New Insights into Nasal Microbiome and Antifungal Resistance: Implications for Infection Control

A large nasal microbiome study showed that persistent Staphylococcus aureus carriers have markedly reduced species richness and S. aureus–dominant nasal communities in a cross-sectional cohort of >1,000 individuals—findings with immediate clinical relevance. The analysis used cross-sectional sampling of nasal swabs to classify persistent carriage and compare community structure across carrier groups. Collectively, these data reframe screening priorities toward identifying microbiome-driven persistent carriers.

The report found specific commensal taxa—S. epidermidis, Dolosigranulum pigrum, Moraxella catarrhalis—were underrepresented in persistent carriers in the cross-sectional sampling of nasal swabs from >1,000 individuals. The taxonomic signal emerged from DNA sequencing alongside standard culture to map community composition across persistent, intermittent, and non-carriers, making loss of these commensals a plausible facilitator of S. aureus dominance and reduced colonization resistance.

Competition for niche space, niche exclusion, and direct microbial interactions provide plausible mechanisms by which S. aureus outcompetes other taxa, although these observations do not establish causality on their own. Compared with prior smaller studies, this larger dataset identifies a reproducible microbiome signature associated with persistent carriage rather than random or host-only colonization patterns; the evidence supports reframing carrier status as a microbiome-influenced trait.

Machine-learning models trained on microbiome composition predicted persistent colonization with high accuracy in the study, supporting a potential diagnostic signal from community profiles. Microbiome profiling could therefore augment carrier-risk prediction alongside traditional clinical risk factors to refine screening decisions, but operational validation in prospective clinical cohorts is required before routine implementation.