Bacterial biofilms and the pathophysiology of chronic rhinosinusitis

Abstract

Biofilms represent an important influence on the pathophysiology of CRS. Further understanding of biofilm interactions and microbial organism behavior will provide us with future treatment modalities for this disease.

Optical coherence tomography for biofilm detection in chronic rhinosinusitis with nasal polyposis

“…Chronic rhinosinusitis (CRS) is a common inXammatory disease with heterogeneous background [1,2]. In rhinological practice, CRS is responsible for a great amount of medical visits and one of the main reasons for antibiotic treatment and sick leave [1].…”

“…CRS with nasal polyposis (CRSwNP) is a separate diagnostic entity, which is currently thought to be a complex immunological disease aVected by multiple factors [1]. These are immunological disorders, bronchial asthma, aspirin intolerance, ASA-syndrome, genetic diseases (cystic Wbrosis, Kartagener's disease), Staphylococcus superantigens, and fungal infections [1][2][3]. Recently, bacterial and fungal bioWlms with consecutive inXammatory reactions have been suspected to be the main etiologic factors of nasal polyp formation in CRS [2,[4][5][6].…”

“…Furthermore, presence of bioWlms could be a great therapeutic problem on the surface of diVerent surgical implants, which might be responsible for antibiotic-and antimycotic-resistant postoperative infections [11]. Bacterial-and fungal colonies exist as free planktonic prokaryote-or eukaryote cells or as complex bioWlm webs [2,7]. BioWlm formation provides a great evolutionary advantage for bacterial-or fungal survival and proliferation [2,7].…”

“…Bacterial-and fungal colonies exist as free planktonic prokaryote-or eukaryote cells or as complex bioWlm webs [2,7]. BioWlm formation provides a great evolutionary advantage for bacterial-or fungal survival and proliferation [2,7]. BioWlms are characterized by a self-produced threedimensional extracellular matrix that consists of water, polysaccharides, proteins, and nucleic acids [7,9].…”

“…This resistance mechanism is based on the physical barrier formed by the polysaccharide matrix that blocks the diVusion of antibiotics, antimycotics, superoxides, immunglobulins, and opsonins [6,7,12]. BioWlms can be formed by individual-or mixed species of bacteria and fungi that usually cannot be cultured and isolated by conventional microbiological protocols; therefore, diagnosis is often uncertain [2,7,8]. Nevertheless, bioWlms can be detected by diYcult, expensive, and time-consuming protocols of scanning electron microscopy (SEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM), and recently by microbe-speciWc Xuorescent in situ hybridization (FISH) [8,13,14].…”