The nasal and skin microbiome are associated with disease severity in pediatric atopic dermatitis

Abstract

Background

Alterations of the skin microbiome have been associated with atopic dermatitis (AD) and its severity. The nasal microbiome in relation to AD severity is less well studied.

Objective

We aimed to characterize the nasal and skin microbiome in children with AD in relation to disease severity. Additionally, we explored differences and correlations between the nasal and skin communities.

Methods

We cross‐sectionally characterized the microbial composition of 90 nasal and 108 lesional skin samples from patients with AD, using 16S‐rRNA sequencing. Additional quantitative (q)PCR for Staphylococcus (S.) aureus and S. epidermidis was performed on the skin samples and AD severity was estimated using the self‐administered eczema area and severity index.

Results

We found an association between the microbial composition and AD severity in both the nose and skin samples (R²=2.6%; p=0.017 and R²=7.0%; p=0.004), strongly driven by staphylococci. However, other species also contributed, such as Moraxella in the nose. Skin lesions were positive for S. aureus in 50% of the children and the presence and load of S. aureus was not associated with AD severity. Although the nose and skin harbor distinct microbial communities (n=48 paired samples; p<0.001), we found that correlations exist between species in the nose and (other) species on the skin.

Conclusion

Our results indicate that both the nasal and skin microbiome are associated with AD severity in children and that next to staphylococci, other species contribute to this association.

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