Association of Head Lice Infestation with Staphylococcal Dysbiosis: Molecular Identification of Pediculus capitis and Staphylococcal Profiling in School Children.

BACKGROUND

Head lice infestations are a widespread health problem among school-aged children globally. Nevertheless, the importance of lice as initiators of scalp microbiome changes and as causes of secondary bacterial superinfections remains poorly understood. The paper aims to examine the PCR-based identification of head lice and to assess the epidemiological relationship between head lice infestation and scalp colonization by Staphylococcus species.

METHODS

An analytical cross-sectional study was conducted on 100 primary school children (50 infested and 50 controls) aged between 5 and 12 years in the governorate of Nineveh (Iraq). The molecular identification of head lice was performed by amplifying the COX1 gene, and the comprehensive Staphylococcal profiling of scalp swabs was performed using culture and 16S rRNA gene amplification.

RESULTS

Molecular analysis using COX1 gene specific amplification showed the presence of P. humanus capitis in 93.9% of the collected samples. The microbiological tests showed profound staphylococcal dysbiosis: Staphylococcus aureus was detected in 74% of infested children and absent in the control group (0%), indicating a highly significant association (χ2=58.73, p<0.001). Conversely, the commensal Staphylococcus epidermidis was found predominantly in healthy controls (66%) but significantly less frequently in infested children (26%).

CONCLUSION

The pathogenic S. aureus prevails on the scalp of children with head lice with a striking shift, which illustrates a clinically significant interaction of ectoparasitic infestation with staphylococcal dysbiosis. The results also suggest that pediculosis is a risk factor for S. aureus overgrowth and emphasize the need for combined treatment strategies that address lice and bacterial complications.