Staphylococcus aureus nasal colonization increases the risk of cedar pollinosis

J Gen Fam Med. 2022 Mar 1;23(3):172-176. doi: 10.1002/jgf2.530. eCollection 2022 May.

Abstract

Background: One-third of the people in Japan are colonized with Staphylococcus aureus (S. aureus) and suffer from virulence factor-mediated subclinical inflammation of the nares. We investigated whether subclinical inflammation contributed to cedar pollinosis affecting 20 million people annually.

Methods: The study participants were 814 inhabitants of the A or B prefectures. We compared the colonization rate and population structure of S. aureus, in association with the prevalence of cedar pollinosis, between participants in these two areas.

Results: A prefecture had twice the annual amount of airborne cedar pollen compared with B. The prevalence of cedar pollinosis was significantly higher in A (23.5%) than in B (13.1%) (p = 0.0004). Moreover, the prevalence of cedar pollinosis was higher in female participants (23.3%) than in male participants (14.7%) (p = 0.003). In addition, the prevalence of cedar pollinosis was higher in S. aureus carriers (24.2%) than in S. aureus noncarriers (17.9%) (p = 0.03). The isolation rate of clonal complex (CC) 508 was higher in the A group (21%) than in the B group (7%) (p = 0.015).

Conclusion: Nasal colonization of S. aureus is a major risk factor for cedar pollinosis. However, the direct mechanism of this risk is currently unknown.

Keywords: MLST; Staphylococcus aureus; cedar pollinosis; clonal complex.