title: Nasal carriage of Staphylococcus aureus and endonasal activity in Wegener s granulomatosis as compared to rheumatoid arthritis and chronic Rhinosinusitis with nasal polyps.
abstract: OBJECTIVE
  Nasal colonisation with Staphylococcus aureus (S. aureus) has been implicated in Wegener's granulomatosis (WG) disease activity. In this study, the frequency of nasal colonisation with S. aureus in WG was compared to healthy and disease control groups for the first time. Moreover, endonasal activity was correlated to colonisation.
  
  
  METHODS
  Nasal carriage of S. aureus of a well-defined group of 89 patients with WG was compared to 40 patients with chronic rhinosinusitis with nasal polyps (CRS), 35 patients with rheumatoid arthritis (RA), 50 hospital staff members and 25 subjects without regular hospital contact and correlation analysis of nasal carriage and endonasal activity of WG was performed.
  
  
  RESULTS
  WG patients showed significantly higher rates (72%) of nasal colonisation with S. aureus compared to CRS patients (28%) and healthy subjects without regular hospital contact (25%, 95%-CI), but not to RA patients (46%) and hospital staff members (58%). WG patients with nasal carriage of S. aureus had significantly higher endoscopically proven endonasal activity (p=0.01), significantly more often first manifestation of WG in the upper respiratory tract (p=0.02) and higher relapse-rates (p=0.052) than WG patients without such carriage.
  
  
  CONCLUSIONS
  Endonasal activity in WG is associated with higher nasal S. aureus colonisation rates and subsequent higher relapse rates. The higher frequency of S. aureus colonisation could be a consequence of a recently shown mucosal barrier defect in WG and facilitate chronic inflammation and granuloma formation in the upper respiratory tract.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, Kiel, Germany. laudien@hno.uni-kiel.de
authors.forename: Martin
authors.initials: M
authors.lastname: Laudien
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Gadola
authors.forename: Rainer
authors.initials: R
authors.lastname: Podschun
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hedderich
authors.forename: Jens
authors.initials: J
authors.lastname: Paulsen
authors.forename: Eva
authors.initials: E
authors.lastname: Reinhold-Keller
authors.forename: Elena
authors.initials: E
authors.lastname: Csernok
authors.forename: Petra
authors.initials: P
authors.lastname: Ambrosch
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hellmich
authors.forename: Frank
authors.initials: F
authors.lastname: Moosig
authors.forename: Wolfgang L
authors.initials: WL
authors.lastname: Gross
authors.forename: Hany
authors.initials: H
authors.lastname: Sahly
authors.forename: Peter
authors.initials: P
authors.lastname: Lamprecht
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000382:microbiology; D002353:Carrier State / Q000453:epidemiology; D002908:Chronic Disease; D014890:Granulomatosis with Polyangiitis / Q000453:epidemiology* / Q000382:microbiology; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology; D009298:Nasal Polyps / Q000453:epidemiology* / Q000382:microbiology; D012008:Recurrence; D012220:Rhinitis / Q000453:epidemiology / Q000382:microbiology; D012852:Sinusitis / Q000453:epidemiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic