Microbiology of Middle Meatus in Chronic Rhinosinusitis

Araújo, Elisabeth; Dall, Celso; Cantarelli, Vladmir; Pereira, Alexandre da Costa; Mariante, Afonso Ravanello

doi:10.1016/s1808-8694(15)30108-7

Cited by 31 publications

(27 citation statements)

References 28 publications

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“…On the whole, the organisms identified in this study were very similar to those identified in previous culture-based investigations into the microflora of CRS patients. Thus, staphylococci (both S. aureus and coagulase-negative staphylococci) and α-haemolytic streptococci were the most commonly isolated organisms, in agreement with published reports [18], [20]–[22]. Corynebacteria were isolated from seven CRS patients, and several potential pathogens were identified, including M. catarrhalis , Neissseria spp.…”

Section: Discussionsupporting

confidence: 89%

“…The role of fungi in CRS is currently unclear. Culture-based studies have reported very low rates of isolation of fungi from CRS samples [20], [22], whereas the direct microscopic analysis of eosinophilic mucin in some cases detects fungi in 100% of patient samples [45]. In the patient cohort analysed here, CRS appeared to be of a non-fungal aetiology.…”

Section: Discussionmentioning

confidence: 82%

“…However, their contribution to disease pathogenesis is unclear [20], [22]. Enterobacteriaciae have been frequently isolated from CRS patients [20]–[22], and this group of organisms was represented here by C. koseri , E. aerogenes , E. coli , and K. pneumoniae . There has been some debate about the presence of obligate anaerobes in paranasal sinuses of CRS patients.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of a Marine Bacterial Nuclease against Biofilm Forming Microorganisms Isolated from Chronic Rhinosinusitis

et al. 2013

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BackgroundThe persistent colonization of paranasal sinus mucosa by microbial biofilms is a major factor in the pathogenesis of chronic rhinosinusitis (CRS). Control of microorganisms within biofilms is hampered by the presence of viscous extracellular polymers of host or microbial origin, including nucleic acids. The aim of this study was to investigate the role of extracellular DNA in biofilm formation by bacteria associated with CRS.Methods/Principal FindingsObstructive mucin was collected from patients during functional endoscopic sinus surgery. Examination of the mucous by transmission electron microscopy revealed an acellular matrix punctuated occasionally with host cells in varying states of degradation. Bacteria were observed in biofilms on mucosal biopsies, and between two and six different species were isolated from each of 20 different patient samples. In total, 16 different bacterial genera were isolated, of which the most commonly identified organisms were coagulase-negative staphylococci, Staphylococcus aureus and α-haemolytic streptococci. Twenty-four fresh clinical isolates were selected for investigation of biofilm formation in vitro using a microplate model system. Biofilms formed by 14 strains, including all 9 extracellular nuclease-producing bacteria, were significantly disrupted by treatment with a novel bacterial deoxyribonuclease, NucB, isolated from a marine strain of Bacillus licheniformis. Extracellular biofilm matrix was observed in untreated samples but not in those treated with NucB and extracellular DNA was purified from in vitro biofilms.Conclusion/SignificanceOur data demonstrate that bacteria associated with CRS form robust biofilms which can be reduced by treatment with matrix-degrading enzymes such as NucB. The dispersal of bacterial biofilms with NucB may offer an additional therapeutic target for CRS sufferers.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Efficacy of a Marine Bacterial Nuclease against Biofilm Forming Microorganisms Isolated from Chronic Rhinosinusitis

et al. 2013

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“…Hsu et al [24], Nadel et al [25], and Araujo et al [26] observed gram-negative microbes in 327 (26 %) infected patients, whereas Mantovani et al [23] observed gram-negative microbes in 58.6 % of infected patients. The predominant isolates in these studies were P. aeruginosa and H. influenzae.…”

Section: Discussionmentioning

confidence: 99%

The pathophysiological role of bacterial biofilms in chronic sinusitis

Długaszewska

Leszczyńska

Lenkowski

et al. 2015

Eur Arch Otorhinolaryngol

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Chronic rhinosinusitis (CRS) is a very common disorder that remains poorly understood from a pathogenic standpoint. Recent research on the pathogenesis of CRS has been focused on the potential role of biofilms in this chronic infection. The aim of this study was to assess the sinuses’ microflora and biofilm formation on the sino-nasal mucosa in patients with CRS. Paranasal sinus mucosa specimens were harvested at the time of functional endoscopic sinus surgery (FESS). Classical microbiology techniques for the isolation and identification of sinus mucosa microbial flora were used. Scanning electron microscopy (SEM) was used to detect biofilm on the surface of mucosa. A microtiter plate assay for in vitro biofilm formation was employed, divided into three aliquots. One part was assessed for bacterial presence, utilizing an API manual system and the Vitek® 2 Compact system. The two remaining aliquots were tested by in vitro conventional microbiological assay with the use of the Infinite M200 (Tecan) microtiter plate reader, and also by scanning electron microscopy (SEM). A microbiological examination of mucosal specimens had taken during FESS operation revealed the presence of various types of bacteria in 29 out of 30 tested samples. Out of 62 different strains isolated from patients with CRS, 23 strains of coagulase-negative Staphylococcus epidermidis and 6 strains of Escherichia coli were the most frequently isolated microorganisms, accounting for 37.1 and 9.7 %, respectively. Among the 62 isolated strains, 58 were used to assess biofilm formation. From the total of 58 isolates, 8.6 % were strong biofilm producers, 20.7 % were moderate, and 70.7 % of isolates were considered to be non- or weak biofilm producers. SEM of the 30 nasal concha mucosal samples taken from patients with CRS revealed biofilm in 23 specimens. A marked destruction of the epithelium was observed, with variation in degrees of severity, from disarrayed cilia to complete absence of cilia. The vast majority of nasal concha mucosal samples of patients affected by chronic sinusitis presented with biofilm formation. Our study showed that 76.7 % of patients having FESS for CRS had evidence of biofilms on SEM micrographs. Although certain detection methods could lead to various discrepancies in the amount of biofilm produced, the consistent demonstration of biofilms in patients with CRS suggests that this convoluted three-dimensional structures might play a significant role in either the pathogenesis or persistence of chronic rhinosinusitis.

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“…To date, microbiota analysis of the nasal and sinus from CRS patients has been performed using standard lab techniques. S. epidermidis levels were found to be higher in controls when compared to CRS [16]. Upon comparison of ARS and CRS, there was a greater increase in the levels of gramnegative rods, S. aureus, and anaerobes in CRS [17][18][19][20][21][22][23][24][25].…”

Section: Crs Nasal and Sinus Microbiotamentioning

confidence: 99%