A Distinct Nasal Microbiota Signature in Peritoneal Dialysis Patients

RATIONALE & OBJECTIVE. The nasal passages harbor both commensal and pathogenic bacteria. In this study, we sought to characterize the anterior nasal microbiota in PD patients using 16S rRNA gene sequencing. STUDY DESIGN. Cross-sectional. SETTING & PARTICIPANTS. We recruited 32 PD patients, 37 kidney transplant (KTx) recipients, 22 living donor/healthy control (HC) participants and collected anterior nasal swabs at a single point in time. PREDICTORS. We performed 16S rRNA gene sequencing of the V4-V5 hypervariable region to determine the nasal microbiota. OUTCOMES. Nasal microbiota profiles were determined at the genus level as well as the amplicon sequencing variant level. ANALYTICAL APPROACH. We compared nasal abundance of common genera among the 3 groups using Wilcoxon rank sum testing with Benjamini-Hochberg adjustment. DESeq2 was also utilized to compare the groups at the ASV levels. RESULTS. In the entire cohort, the most abundant genera in the nasal microbiota included: Staphylococcus, Corynebacterium, Streptococcus, and Anaerococcus. Correlational analyses revealed a significant inverse relationship between the nasal abundance of Staphylococcus and that of Corynebacterium. PD patients have a higher nasal abundance of Streptococcus than KTx recipients and HC participants. PD patients have a more diverse representation of Staphylococcus and Streptococcus than KTx recipients and HC participants. PD patients who concurrently have or who developed future Staphylococcus peritonitis had a numerically higher nasal abundance of Staphylococcus than PD patients who did not develop Staphylococcus peritonitis. LIMITATIONS. 16S RNA gene sequencing provides taxonomic information to the genus level. CONCLUSIONS. We find a distinct nasal microbiota signature in PD patients compared to KTx recipients and HC participants. Given the potential relationship between the nasal pathogenic bacteria and infectious complications, further studies are needed to define the nasal microbiota associated with these infectious complications and to conduct studies on the manipulation of the nasal microbiota to prevent such complications.