A Distinct Nasal Microbiota Signature in Peritoneal Dialysis Patients.

Key Points: , , , and are the most common genera in the anterior nares. The nasal abundance of is inversely correlated with the nasal abundance of . Peritoneal dialysis patients have a distinctly diverse representation of and in their anterior nares.

Background: The nasal passages harbor both commensal and pathogenic bacteria that can be associated with infectious complications. The nasal microbiome in peritoneal dialysis (PD) patients, however, has not been well characterized. In this study, we sought to characterize the anterior nasal microbiota in PD patients and assess its association with PD peritonitis.

Methods: In this study, we recruited 32 PD patients, 37 kidney transplant (KTx) recipients, and 22 living donor/healthy control (HC) participants and collected their anterior nasal swabs at a single point in time. We followed the PD patients for future development of peritonitis. We performed 16S ribosomal RNA (rRNA) gene sequencing of the V4–V5 hypervariable region to determine the nasal microbiota. We compared nasal abundance of common genera among the three groups using Wilcoxon rank-sum test with Benjamini–Hochberg adjustment. DESeq2 was also used to compare the groups at the amplicon sequence variant levels.

Results: In the entire cohort, the most abundant genera in the nasal microbiota included , , , and . Correlational analyses revealed a significant inverse relationship between the nasal abundance of and that of . PD patients have a higher nasal abundance of than KTx recipients and HC participants. PD patients have a more diverse representation of and than KTx recipients and HC participants. PD patients who concurrently have or who developed future peritonitis had a numerically higher nasal abundance of than PD patients who did not develop peritonitis.

Conclusions: We find a distinct nasal microbiota signature in PD patients compared with 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.