Staphylococcus aureus nasal colonization and asthma in adults: systematic review and meta-analysis

Publication date: Available online 5 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Young-Chan Kim, Ha-Kyeong Won, Ji Won Lee, Kyoung-Hee Sohn, Min-Hye Kim, Tae-Bum Kim, Yoon-Seok Chang, Byung-Jae Lee, Sang-Heon Cho, Claus Bachert, Woo-Jung Song

Abstract

Background

Staphylococcus aureus (SA) is a frequent colonizer in human and it is known to be associated with chronic allergic diseases including asthma. Recent individual studies suggested that nasal SA colonization may be positively associated with asthma.

Objective

To examine relationships between nasal SA colonization and asthma prevalence and activity in adults.

Methods

Electronic databases were searched for studies published until June 2018. Studies that reported nasal SA colonization prevalence and asthma outcome (prevalence and disease activity) in general adult populations or chronic rhinosinusitis (CRS) patients were included. Random effects meta-analyses were performed to calculate pooled odds ratio (OR) of the relationships. Subgroup analysis was conducted for the presence of nasal polyps within CRS populations.

Results

A total of 21 cross-sectional studies were identified, and the data from 16 studies using culture methods for SA detection were meta-analyzed (5 general population-based studies and 11 CRS patient studies). In studies of general populations, nasal SA colonization had significant relationships with asthma prevalence (OR 1.19; 95% confidence interval 1.06-1.34; I² = 1%). In CRS patient studies, positive associations were also found but had a considerable heterogeneity (OR 1.87; 95% CI 1.18-2.97; I² = 72%). However, the results were comparable between CRS with and without nasal polyps.

Conclusions

This study demonstrated modest but significant relationships between nasal SA colonization and asthma, supporting potential roles of SA in adult asthma patients. Further longitudinal cohort and intervention studies are warranted to identify host determinants and to clarify causality of the relationships.