Association between nasal and nasopharyngeal bacterial colonization in early life and eczema phenotypes

• Published in: Clinical and experimental allergy 2021-05, Vol.51 (5), p.716-725
• Main Authors: Hu, Chen, Duijts, Liesbeth, Meel, Evelien R., Looman, Kirsten I. M., Kiefte‐de Jong, Jessica C., Pardo, Luba M., Hijnen, DirkJan, Pasmans, Suzanne G. M. A., Jongste, Johan C., Moll, Henriette A., Nijsten, Tamar
• Format: Article
• Language: English
• Subjects: atopic dermatitis; Bacteria; birth cohort; Carrier State - epidemiology; Carrier State - microbiology; Child; Child, Preschool; Children; Colonization; Dermatitis, Atopic - epidemiology; Dermatitis, Atopic - physiopathology; Eczema; Female; Haemophilus; Haemophilus influenzae - isolation & purification; Humans; Infant; Influenza; Male; Moraxella catarrhalis; Moraxella catarrhalis - isolation & purification; nasal bacteria; Nasopharynx - microbiology; Nose - microbiology; Original; ORIGINAL ARTICLES; Penicillin; Phenotypes; Population studies; Regression analysis; S. aureus colonization; Staphylococcus; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Streptococcus infections; Streptococcus pneumoniae - isolation & purification
• ISSN: 0954-7894; 1365-2222
• DOI: 10.1111/cea.13869

Background An association has been reported between early life Staphylococcus aureus nasal carriage and higher risk of childhood eczema, but it is unclear whether this relationship is causal and associations with other bacterial species are unclear. Objective To examine the associations of early life nasal and nasopharyngeal bacterial carriage with eczema phenotypes, and the direction of any associations identified. Methods Among 996 subjects of a population‐based prospective cohort study, nasal swabs for Staphylococcus  aureus, and nasopharyngeal swabs for Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae were collected and cultured from age 6 weeks to 6 years. Never, early, mid‐, late transient and persistent eczema phenotypes were identified from parental‐reported physician‐diagnosed eczema from age 6 months until 10 years. Multinomial regression models and cross‐lagged models were applied. Results Staphylococcus aureus nasal carriage at 6 months was associated with an increased risk of early transient and persistent eczema (OR (95% CI): 2.69 (1.34, 5.39) and 4.17 (1.12, 15.51)). The associations between Staphylococcus aureus nasal carriage and eczema were mostly cross‐sectional, and not longitudinal. No associations of Staphylococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenza nasopharyngeal bacterial carriage with eczema and eczema phenotypes were observed (OR range (95% CI): 0.71 (0.35, 1.44) to 1.77 (0.84, 3.73)). Conclusions Early life Staphylococcus aureus nasal carriage, but not Staphylococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenza nasopharyngeal carriage, was associated with early transient and persistent eczema. Staphylococcus aureus nasal carriage and eczema were mostly cross‐sectionally associated, and not longitudinally, making a causal relationship in either direction unlikely. Early life Staphylococcus aureus nasal carriage was associated with an increased risk of early transient and persistent eczema. S. aureus nasal carriage and eczema were mostly cross‐sectionally associated, and not longitudinally, making a causal relationship in either direction unlikely. No associations of Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenza nasopharyngeal bacterial carriage with eczema and eczema phenotypes were observed.