Abstract
We investigated Staphylococcus aureus diversity, genetic factors, and humoral immune responses against antigens via genome analysis of S. aureus isolates from chronic rhinosinusitis (CRS) patients in a long-term follow-up. Of the 42 patients who provided S. aureus isolates and serum for a previous study, 34 could be included for follow-up after a decade. Clinical examinations were performed and bacterial samples were collected from the maxillary sinus and nares. S. aureus isolates were characterized by whole-genome sequencing, and specific anti-staphylococcal IgG in serum was determined using protein arrays. S. aureus was detected in the nares and/or maxillary sinus at both initial inclusion and follow-up in 15 of the 34 respondents (44%). Three of these (20%) had S. aureus isolates from the same genetic lineage as at inclusion. A low number of single-nucleotide polymorphisms (SNPs) were identified when comparing isolates from nares and maxillary sinus collected at the same time point. The overall change of antibody responses to staphylococcal antigens over time showed great variability, and no correlation was found between the presence of genes encoding antigens and the corresponding anti-staphylococcal IgG in serum; thus our findings did not support a role, in CRS, of the specific S. aureus antigens investigated.
Highlights
In 15/34 (44%) patients, S. aureus was present in the nares and/or maxillary sinus at both initial inclusion and follow-up, and in 6/34 (18%) patients, S. aureus was present in both the nares and the maxillary sinus at both time points
Among the 66 S. aureus isolates, 110,026 single-nucleotide polymorphisms (SNPs) were identified across the conserved core genome of 77.5% (~2.21 Mbp), but generally a low number of SNPs was observed within hosts when comparing S. aureus isolates from the nares and maxillary sinus collected at the same time point
All but one of the 27 paired S. aureus isolates collected from the nares and maxillary sinus collected at the same time point (C1 or C2) displayed the same clonal complex (CC)
Summary
Chronic rhinosinusitis (CRS) affects about 10% of the European population, and is a burdensome disease in which Staphylococcus aureus is suggested to have a potential role [1]. The presence of S. aureus in healthy maxillary sinuses is low [2], but it is commonly observed in patients with CRS [3,4,5]. S. aureus is generally considered to be a harmless commensal which colonizes the nares intermittently or persistently in 20–70% of healthy individuals [6,7,8]. It has the potential to cause invasive diseases ranging from mild superficial skin disorders such as folliculitis to serious conditions including sepsis
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