Summary Staphylococcus aureus is a representative constituted  pathogen related with the major community and hospital acquired sickness and has been taken into consideration for a long time  as a major problem of Public Health,Several virulence factors engaged  in the pathogenesis of S. aureus strains Perhaps the most notable virulence factors associated with this microorganism are the heat-stable enterotoxins that cause the sporadic food-poisoning syndrome or foodborne outbreaks (Martin et al.,2003).

Hypothesis: The pathogenesis of Allergic rhinitis(AR)  has been a hot subject , recent studies had  suggested that Staphylococcus aureus excretes exotoxins that may act as superantigens and can influence the activity of both immune modulatory and pro inflammatory effector cell type and therefore, may have a potentially important role in the pathogenesis of chronic inflammatory disease  or lead to exacerbation of upper airway disease

Methodology A case –control study has been conducted to determine the prevalence of enterotoxin producing Staphylococcus aureus in the nasal cavities of patients with allergic rhinitis during the period from March 2014 to November 2014, 100 patients with Allergic rhinitis and 100 control subjects, the patients attended Al-Sadder Medical City, outpatient clinic of ENT in Najaf city. For isolation of S. aureus, a nasal swab was taken from each of the 100 patients and 100 controls by using a sterile cotton swab. Isolates were identified by a conventional test and then confirmed by Biomerieux Vitek 2 Compact Automated Microbial Identification. The super antigen genes (SEA, SEB,SEC,SED,SEE,and TSST) were detected by using conventional PCR on the isolate then an enzyme immune assay RIDASCREEN ® SET A, B,C,D,Epreformed on broth culture of  these isolates in order to identify the enterotoxins production or libration.

Result: Nasal S. aureus carriage was significantly more frequent in patients with allergic rhinitis than in non-allergic controls (P < 0.001),(Odds=3.4306 CI=1.8-6.26).The distribution of toxigenic S. aureus that recover from allergic rhinitis patients by PCR test was (63.16%) and (26.32%) from control groups and the difference was non-significant P= 0.434.The most frequently detected enterotoxin was staphylococcal enterotoxin B (SEB).ELISA test seem to be more sensitive for (SED, SEC, and SEE) and less sensitive for (SEA and SEB), however the specificity of ELISA is better in (SEB, SEC, SED, SEE than SEA

Conclusion: We have demonstrated that the rate of nasal carriage of Staphylococcus aureus in allergic rhinitis patients was significantly higher than that of control subject,-Staphylococcus aureus isolated from allergic rhinitis patients have a probably a relationship with the disease and their superantigen have been a role in triggering and exacerbation of the disease

Keyword; Allergic rhinitis,Staphylococcus aureus, Superantigens

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Thanaa Shams Al-deen AL-Turaihi Lecturer

Department of Medical Microbiology, Kufa College of Medicine

Ph.D Student in Kufa College of Medicine Department of Medical Microbiology 

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