The frequency of nasal carriage in chronic urticaria patients

Abstract

Chronic urticaria is characterized by oedema of the skin and mucous membranes. Although many agents have been implicated, aetiology is unknown in 70 to 75% of patients. Infections and foci of chronic infections are most commonly held responsible for chronic urticaria. In this study, the frequency of nasal carriage as the occult focus of infection and sensitivity to antimicrobials are explored in patients with chronic urticaria. Ninety-four patients with chronic urticaria and 30 controls participated in the study, which was carried out at the Ege university medical faculty, department of dermatology between January 2004 and January 2005. Nasal swab specimens were taken from the patients and controls and incubated at 37 degrees C degrees for 48 h, and inoculated on standard bacterial medium (blood agar). Antimicrobial susceptibility of a growth from isolates of the nasal swab specimens was conducted. Data were analysed statistically using chi-square and Mann-Whitney U-tests. Ninety-four patients with chronic urticaria (72.3% female and 27.7% male) and 30 controls (63.3% female and 36.7% male) comprised the study group. Mean age of the patients and controls were 42.6 and 33.8 years, respectively. Staphylococcus aureus was detected in swab specimens from the nasal cavity in 50 of the 94 patients (53.2%) with chronic urticaria and four of the 30 controls (13.3%). Testing revealed that the most susceptible antibiotics were cefaclor, ceftriaxone, amoxycillin-clavulanic acid, amikacin, netilmicin, and fucidic acid. Growth on cultures prepared from nasal swab specimens of chronic urticaria patients was statistically higher than the control group. We detected resistance to growth against mupirocin, an antibiotic frequently used in nasal carriage. High nasal carriage of Staphylococcus aureus in patients with chronic urticaria compared to controls suggests that nasal carriage as a focus of infection should be kept in mind as aetiology.