PMID- 32995882 OWN - NLM STAT- MEDLINE DCOM- 20210423 LR - 20210423 IS - 1462-0332 (Electronic) IS - 1462-0324 (Linking) VI - 60 IP - 2 DP - 2021 Feb 1 TI - Genetic diversity of Staphylococcus aureus influences disease phenotype of systemic lupus erythematosus. PG - 958-966 LID - 10.1093/rheumatology/keaa519 [doi] AB - OBJECTIVE: We investigated the genetic diversity, molecular epidemiology and evolutionary dynamics of Staphylococcus aureus (SA) isolated from SLE patients by means of phylogenetic analysis. METHODS: Consecutive SLE patients (ACR 1997 criteria) were enrolled: clinical/laboratory data were collected and nasal swab for SA identification was performed. On the basis of the translation elongation factor (tuf) gene, a phylogenetic analysis was performed to investigate relationships and to assess significant clades. Selective pressure analysis was used to investigate the evolution of the SA tuf gene. The gene sequences from non-SLE individuals, downloaded from the GenBank database, were compared through phylogenetic analysis with the tuf gene from SLE patients. RESULTS: We enrolled 118 patients [M/F 10/108; median (interquartile range (IQR)) age 45.5 (13.2) years; median (IQR) disease duration 120 (144) months]. Twenty-four patients (20.3%) were SA carriers (SA+), three of them MRSA. SA+ SLE showed significantly higher SLEDAI-2k values [SA+: median (IQR) 2 (3.75); SA-: 0 (2); P = 0.04]. The phylogenetic analysis, restricted to 21 non-MRSA SA+, revealed a statistically supported larger clade (A, n = 17) and a smaller one (B, n = 4). Patients located in clade A showed a significantly higher prevalence of joint involvement (88.2%) in comparison with clade B (50.0%, P < 0.0001) and SA- (62.7%, P < 0.0001). Haematological manifestations were significantly more frequent in clade A (64.7%) compared with B (50.0%, P = 0.004). CONCLUSION: We suggest a possible role of SA nasal carriage status in SLE disease activity. Moreover, our findings support the hypothesis that bacterial genetic variants may be associated with specific disease features. CI - (c) The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com. FAU - Ceccarelli, Fulvia AU - Ceccarelli F AD - Lupus Clinic, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Rome, Italy. FAU - Lo Presti, Alessandra AU - Lo Presti A AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. FAU - Olivieri, Giulio AU - Olivieri G AD - Lupus Clinic, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Rome, Italy. FAU - Angeletti, Silvia AU - Angeletti S AD - Unit of Clinical Laboratory Science, University campus Bio-Medico of Rome, Rome, Italy. FAU - Perricone, Carlo AU - Perricone C AD - Dipartimento di Medicina, Sezione di Reumatologia, Universita degli Studi di Perugia, Perugia, Italy. FAU - Garufi, Cristina AU - Garufi C AD - Lupus Clinic, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Rome, Italy. FAU - Iaiani, Giancarlo AU - Iaiani G AD - DAI Malattie Infettive e Tropicali, Azienda Policlinico Umberto I, Rome, Italy. FAU - De Florio, Lucia AU - De Florio L AD - Unit of Clinical Laboratory Science, University campus Bio-Medico of Rome, Rome, Italy. FAU - Antonelli, Francesca AU - Antonelli F AD - Unit of Clinical Laboratory Science, University campus Bio-Medico of Rome, Rome, Italy. FAU - De Cesaris, Marina AU - De Cesaris M AD - Unit of Clinical Laboratory Science, University campus Bio-Medico of Rome, Rome, Italy. FAU - Giordano, Alessandra AU - Giordano A AD - UOC Microbiologia e Virologia, Azienda Policlinico Umberto I, Rome, Italy. FAU - Amori, Luigino AU - Amori L AD - UOC Microbiologia e Virologia, Azienda Policlinico Umberto I, Rome, Italy. FAU - Spinelli, Francesca Romana AU - Spinelli FR AD - Lupus Clinic, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Rome, Italy. FAU - Alessandri, Cristiano AU - Alessandri C AD - Lupus Clinic, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Rome, Italy. FAU - Valesini, Guido AU - Valesini G AD - Lupus Clinic, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Rome, Italy. FAU - Ciccozzi, Massimo AU - Ciccozzi M AD - Unit of Medical Statistics and Molecular Epidemiology, University campus Bio-Medico of Rome, Rome, Italy. FAU - Conti, Fabrizio AU - Conti F AD - Lupus Clinic, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Rome, Italy. LA - eng PT - Journal Article PL - England TA - Rheumatology (Oxford) JT - Rheumatology (Oxford, England) JID - 100883501 SB - IM MH - Correlation of Data MH - Female MH - Genes, Bacterial/*genetics MH - Genetic Variation MH - Humans MH - Immunity MH - Italy MH - *Joint Diseases/diagnosis/etiology MH - *Lupus Erythematosus, Systemic/diagnosis/epidemiology/microbiology/physiopathology MH - Male MH - Middle Aged MH - Nasal Cavity/*microbiology MH - Patient Acuity MH - Phylogeny MH - *Staphylococcal Infections/diagnosis/immunology MH - Staphylococcus aureus/*genetics MH - Symptom Assessment/methods/statistics & numerical data OTO - NOTNLM OT - disease phenotype OT - pathogenesis OT - phylogenetic analysis OT - staphylococcus aureus OT - systemic lupus erythematosus EDAT- 2020/10/01 06:00 MHDA- 2021/04/24 06:00 CRDT- 2020/09/30 06:16 PHST- 2020/02/19 00:00 [received] PHST- 2020/07/06 00:00 [revised] PHST- 2020/10/01 06:00 [pubmed] PHST- 2021/04/24 06:00 [medline] PHST- 2020/09/30 06:16 [entrez] AID - 5913096 [pii] AID - 10.1093/rheumatology/keaa519 [doi] PST - ppublish SO - Rheumatology (Oxford). 2021 Feb 1;60(2):958-966. doi: 10.1093/rheumatology/keaa519.