The effect of the nasal flora of Sjogren's syndrome

Sjogren syndrome (SS) is a chronic autoimmune disease associated with lymphocyte infiltrations of the exocrine glands. Dryness of the mouth and xerophthalmia develop after infiltration of the lachrymal and salivary glands. Association between Candida colonization and the dryness of the mouth occurring in SS has been previously demonstrated. However, bacterial colonization of the nasal flora has not been studied in patients with SS. In this study, 58 patients with SS and 79 healthy adults were screened by nasal cultures. Gram negative bacillus, staphylococcus and candida were investigated by inoculation with standard methods. Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) colonizations were significantly more common SS patients. The pathogen microorganism colonization is more common in patients with higher focus scores. No significant relationship was found between the pathogen microorganism colonization and age of patients, disease duration, medications used, auto-antibody profile, symptoms of dryness of mouth and xerophthalmia, or Schirmer positivity. These findings demonstrate that there is impairment in normal flora during the course of SSS and that there is an increase in pathogen microorganisms. The alteration in flora could either be associated with the disease activity or with the natural consequence of the dryness. Further studies are needed in order to enlighten whether being the carrier of MRSA and MSSA shown in SS patients constitutes increased infection risk in this patient group.Keywords: Sjogren Syndrome, Nasal S. Aureus carrier