Recent Trends in Bacteriology of Adult Patients with Chronic Rhinosinusitis
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Sample Collection
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Fokkens, W.J.; Lund, V.J.; Mullol, J.; Bachert, C.; Alobid, I.; Baroody, F.; Cohen, N.; Cervin, A.; Douglas, R.; Gevaert, P.; et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol. Suppl. 2012, 23, 1–298. [Google Scholar]
- Thanasumpun, T.; Batra, P.S. Endoscopically-derived bacterial cultures in chronic rhinosinusitis: A systematic review. Am. J. Otolaryngol. 2015, 36, 686–691. [Google Scholar] [CrossRef] [PubMed]
- Sivasubramaniam, R.; Douglas, R. The microbiome and chronic rhinosinusitis. World J. Otorhinolaryngol. Head Neck Surg. 2018, 4, 216–221. [Google Scholar] [CrossRef] [PubMed]
- Manes, R.P.; Batra, P.S. Bacteriology and antibiotic resistance in chronic rhinosinusitis. Facial Plast. Surg. Clin. N. Am. 2012, 20, 87–91. [Google Scholar] [CrossRef]
- Jiang, R.S.; Su, M.C.; Liao, C.Y.; Lin, J.F. Bacteriology of chronic sinusitis in relation to middle meatal secretion. Am. J. Rhinol. 2006, 20, 173–176. [Google Scholar] [CrossRef]
- Wei, H.Z.; Li, Y.C.; Wang, X.D.; Lu, X.X.; Hu, C.H.; He, S.; Liu, X. The microbiology of chronic rhinosinusitis with and without nasal polyps. Eur. Arch. Otorhinolaryngol. 2018, 275, 1439–1447. [Google Scholar] [CrossRef]
- Kim, H.J.; Lee, K.; Yoo, J.B.; Song, J.W.; Yoon, J.H. Bacteriological findings and antimicrobial susceptibility in chronic sinusitis with nasal polyp. Acta Otolaryngol. 2006, 126, 489–497. [Google Scholar]
- Lee, C.W.; Lee, B.J.; Yoo, S.H.; Yi, J.S. Relationship between positive bacterial culture in maxillary sinus and surgical outcomes in chronic rhinosinusitis with nasal polyps. Auris Nasus Larynx 2014, 41, 446–449. [Google Scholar] [CrossRef]
- Cao, P.P.; Li, H.B.; Wang, B.F.; Wang, S.B.; You, X.J.; Cui, Y.H.; Wang, D.Y.; Desrosiers, M.; Liu, Z. Distinct immunopathologic characteristics of various types of chronic rhinosinusitis in adult Chinese. J. Allergy Clin. Immunol. 2009, 124, 478–484. [Google Scholar] [CrossRef]
- Lee, M.; Kim, D.W.; Yoon, H.; So, D.; Khalmuratova, R.; Rhee, C.S.; Park, J.W.; Shin, H.W. Sirtuin 1 attenuates nasal polypogenesis by suppressing epithelial-to-mesenchymal transition. J. Allergy Clin. Immunol. 2016, 137, 87–98. [Google Scholar] [CrossRef]
- Yildirim, A.; Oh, C.; Erdem, H.; Kunt, T. Bacteriology in patients with chronic sinusitis who have been medically and surgically treated. Ear Nose Throat J. 2004, 83, 836–838. [Google Scholar] [CrossRef] [PubMed]
- Brook, I. Bacteriology of chronic sinusitis and acute exacerbation of chronic sinusitis. Arch. Otolaryngol. Head Neck Surg. 2006, 132, 1099–1101. [Google Scholar] [CrossRef] [PubMed]
- Niederfuhr, A.; Kirsche, H.; Riechelmann, H.; Wellinghausen, N. The bacteriology of chronic rhinosinusitis with and without nasal polyps. Arch. Otolaryngol. Head Neck Surg. 2009, 135, 131–136. [Google Scholar] [CrossRef] [PubMed]
- Liu, Q.; Lu, X.; Bo, M.; Qing, H.; Wang, X.; Zhang, L. The microbiology of chronic rhinosinusitis with and without nasal polyps. Acta Otolaryngol. 2014, 134, 1251–1258. [Google Scholar] [CrossRef] [PubMed]
- Tomassen, P.; Vandeplas, G.; Van Zele, T.; Cardell, L.O.; Arebro, J.; Olze, H.; Förster-Ruhrmann, U.; Kowalski, M.L.; Olszewska-Ziąber, A.; Holtappels, G.; et al. Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers. J. Allergy Clin. Immunol. 2016, 137, 1449–1456. [Google Scholar] [CrossRef] [PubMed]
- Hirotsu, M.; Kikuchi, K.; Kusunoki, T.; Kase, K.; Ono, N.; Ikeda, K. Comparison of bacterial examinations between eosinophilic and neutrophilic chronic rhinosinusitis with nasal polyps. Acta Otolaryngol. 2011, 131, 997–1001. [Google Scholar] [CrossRef] [PubMed]
- Araujo, E.; Dall, C.; Cantarelli, V.; Pereira, A.; Mariante, A.R. Microbiology of middle meatus in chronic rhinosinusitis. Braz. J. Otorhinolaryngol. 2007, 73, 549–555. [Google Scholar] [CrossRef]
- Li, H.; Xu, L.; Wang, J.; Wen, Y.; Vuong, C.; Otto, M.; Gao, Q. Conversion of Staphylococcus epidermidis strains from commensal to invasive by expression of the ica locus encoding production of biofilm exopolysaccharide. Infect. Immun. 2005, 73, 3188–3191. [Google Scholar] [CrossRef]
- Zhang, Z.; Adappa, N.D.; Lautenbach, E.; Chiu, A.G.; Doghramji, L.J.; Cohen, N.A.; Palmer, J.N. Coagulase-negative Staphylococcus culture in chronic rhinosinusitis. Int. Forum Allergy Rhinol. 2015, 5, 204–213. [Google Scholar] [CrossRef]
- Cincik, H.; Ferguson, B.J. The impact of endoscopic cultures on care in rhinosinusitis. Laryngoscope 2006, 116, 1562–1568. [Google Scholar] [CrossRef]
- Hamilos, D.L. Chronic rhinosinusitis: Epidemiology and medical management. J. Allergy Clin. Immunol. 2011, 128, 693–707. [Google Scholar] [CrossRef] [PubMed]
- Tichenor, W.S.; Adinoff, A.; Smart, B.; Hamilos, D.L. Nasal and sinus endoscopy for medical management of resistant rhinosinusitis, including postsurgical patients. J. Allergy Clin. Immunol. 2008, 121, 917–927. [Google Scholar] [CrossRef] [PubMed]
- Bhattacharyya, N.; Kepnes, L.J. The risk of development of antimicrobial resistance in individual patients with chronic rhinosinusitis. Arch. Otolaryngol. Head Neck Surg. 2004, 130, 1201–1204. [Google Scholar] [CrossRef] [PubMed][Green Version]
Variable | Bacterial Culture | p-Value | |
---|---|---|---|
Positive (n = 389) | Negative (n = 121) | ||
Age (years), mean ± S.D. | 47.2 ± 17.0 | 46.9 ± 16.7 | 0.889 |
Male gender, number (%) | 237 (60.9) | 75 (62.0) | 0.835 |
Nasal Polyp | Atopy | Asthma | Current Smoker | |||||
---|---|---|---|---|---|---|---|---|
Yes | No | Yes | No | Yes | No | Yes | No | |
No. of patients | 376 | 134 | 51 | 459 | 33 | 477 | 87 | 423 |
Isolation rate, % | 73.9 | 82.8 | 66.7 | 77.3 | 72.7 | 76.5 | 75.9 | 76.4 |
p-value | 0.038 | 0.089 | 0.625 | 0.921 |
Isolated Bacteria [n (%)] | |||
---|---|---|---|
Total Isolates (n = 650) | CRSsNP (n = 196) | CRSwNP (n = 454) | |
Gram-positive aerobic and facultative anaerobic bacteria | |||
Coagulase negative Staphylococcus | 182 (28.0%) | 55 (28.1%) | 127 (28.0%) |
Staphylococcus epidermidis | 159 (24.5%) | 45 (23.0%) | 114 (25.1%) |
Others | 23 (3.5%) | 10 (5.1%) | 13 (2.9%) |
Streptococcus species | 79 (12.2%) | 32 (16.3%) | 47 (10.4%) |
Streptococcus pneumoniae | 30 (4.6%) | 6 (3.1%) | 24 (5.3%) |
Streptococcus constellatus | 22 (3.4%) | 14 (7.1%) | 8 (1.8%) |
Streptococcus viridans | 12 (1.8%) | 5 (2.6%) | 7 (1.5%) |
Streptococcus anginosus | 6 (0.9%) | 3 (1.5%) | 3 (0.6%) |
Streptococcus intermedius | 5 (0.8%) | 4 (2.0%) | 1 (0.2%) |
Streptococcus group C | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Streptococcus group F | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Streptococcus group G | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Streptococcus pseudopneumoniae | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Corynebacterium | 49 (7.5%) | 6 (3.1%) | 43 (9.5%) |
Staphylococcus aureus | 40 (6.2%) | 10 (5.1%) | 30 (6.6%) |
Parvimonas micra | 21 (3.2%) | 13 (6.6%) | 8 (1.8%) |
Peptostreptococcus species | 18 (2.8%) | 2 (1.0%) | 16 (3.5%) |
Others | |||
Peptoniphilus asaccharolyticus | 7 (1.1%) | 2 (1.0%) | 5 (1.1%) |
Enterococcus | 4 (0.6%) | 0 (0.0%) | 4 (0.9%) |
Bacillus | 2 (0.3%) | 1 (0.5%) | 1 (0.2%) |
Micrococcus species | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Gram-positive obligate anaerobic bacteria | |||
Propionibacterium species | 52 (8.0%) | 10 (5.1%) | 42 (9.3%) |
Clostridium species | 3 (0.5%) | 1 (0.5%) | 2 (0.4%) |
Gram-negative aerobic and facultative anaerobic bacteria | |||
Haemophilus species | 37 (5.7%) | 6 (3.1%) | 31 (6.8%) |
Haemophilus influenzae | 33 (5.1%) | 6 (3.1%) | 27 (5.9%) |
Others | 4 (0.6%) | 0 (0.0%) | 4 (0.9%) |
Klebsiella species | 33 (5.1%) | 7 (3.6%) | 26 (5.7%) |
Klebsiella aerogenes | 16 (2.5%) | 3 (1.5%) | 13 (2.9%) |
Klebsiella pneumoniae | 13 (2.0%) | 3 (1.5%) | 10 (2.2%) |
Klebsiella oxytoca | 4 (0.6%) | 1 (0.5%) | 3 (0.7%) |
Enterobacter species | 28 (4.3%) | 9 (4.6%) | 19 (4.2%) |
Citrobacter species | 6 (0.9%) | 0 (0.0%) | 6 (1.3%) |
Others | |||
Eggerthella lenta | 3 (0.5%) | 3 (1.5%) | 0 (0.0%) |
Escherichia coli | 3 (0.5%) | 1 (0.5%) | 2 (0.4%) |
Achromobacter xylosoxidans | 2 (0.3%) | 1 (0.5%) | 1 (0.2%) |
Serratia | 2 (0.3%) | 1 (0.5%) | 1 (0.2%) |
Morganella morganii | 2 (0.3%) | 1 (0.5%) | 1 (0.2%) |
Campylobacter rectus | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Eikenella corrodens | 1 (0.2%) | 1 (0.5%) | 0 (0.0%) |
Gram-negative obligate aerobic bacteria | |||
Pseudomonas aeruginosa | 27 (4.2%) | 14 (7.1%) | 13 (2.9%) |
Moraxella | 5 (0.8%) | 2 (1.0%) | 3 (0.7%) |
Acinetobacter | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Neisseria subflava | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Stenotrophomonas maltophilia | 1 (0.2%) | 1 (0.5%) | 0 (0.0%) |
Gram-negative obligate anaerobic bacteria | |||
Prevotella species | 17 (2.6%) | 11 (5.6%) | 6 (1.3%) |
Fusobacterium species | 4 (0.6%) | 4 (2.0%) | 0 (0.0%) |
Bacteroides | 2 (0.3%) | 2 (1.0%) | 0 (0.0%) |
Porphyromonas species | 1 (0.2%) | 0 (0.0%) | 1 (0.2%) |
Organisms | Eosinophilic CRSwNP (n = 48 Strains) (%) | Non-eosinophilic CRSwNP (n = 38 Strains) (%) | p-Value |
---|---|---|---|
Staphylococcus epidermidis | 46.0 | 26.0 | 0.003 |
Streptococcus species | 8.0 | 16.0 | 0.082 |
Corynebacterium species | 12.9 | 0.0 | <0.001 |
Staphylococcus aureus | 8.0 | 5.0 | 0.390 |
Haemophilus species | 0.0 | 10.9 | 0.001 |
Klebsiella species | 21.0 | 37.0 | 0.013 |
Enterobacter species | 4.0 | 0.0 | 0.043 |
Pseudomonas aeruginosa | 0.0 | 5.0 | 0.024 |
Organisms | 2007–2008 (n = 223 Strains) (%) | 2012–2013 (n = 211 Strains) (%) | 2017–2018 (n = 216 Strains) (%) | p-Value |
---|---|---|---|---|
CNS | 21.5 | 29.4 | 33.3 | 0.006 |
Streptococcus species | 11.2 | 10.0 | 15.3 | 0.196 |
Propionibacterium species | 12.1 | 11.8 | 0.0 | <0.001 |
Corynebacterium species | 11.2 | 7.6 | 3.7 | 0.003 |
Staphylococcus aureus | 8.1 | 4.3 | 6.0 | 0.364 |
Haemophilus species | 5.8 | 3.8 | 7.4 | 0.484 |
Klebsiella species | 4.0 | 0.5 | 10.6 | 0.002 |
Enterobacter species | 6.3 | 2.8 | 3.7 | 0.181 |
Pseudomonas aeruginosa | 2.7 | 1.9 | 7.9 | 0.007 |
Organism Antibiotic Resistance | 2007–2008 (n = 223 Strains) n (%) | 2012–2013 (n = 211 Strains) n (%) | 2017–2018 (n = 216 Strains) n (%) | p-Value |
---|---|---|---|---|
Streptococcus species | ||||
Amoxicillin/clavulanate | 0 (0.0%) | 0 (0.0%) | 2 (0.9%) | 0.082 |
Macrolide a | 8 (3.6%) | 10 (4.7%) | 13 (6.0%) | 0.233 |
Staphylococcus aureus | ||||
Methicillin | 2 (0.9%) | 1 (0.5%) | 2 (0.9%) | 0.977 |
Haemophilus species | ||||
Ampicillin | 8 (34.8%) | 1 (0.5%) | 10 (4.6%) | 0.532 |
Klebsiella species | ||||
ESBL | 1 (0.4%) | 1 (0.5%) | 16 (7.4%) | <0.001 |
Ciprofloxacin | 1 (0.4%) | 0 (0.0%) | 0 (0.0%) | 0.229 |
Enterobacter species | ||||
ESBL | 0 (0.0%) | 6 (2.8%) | 8 (3.7%) | 0.007 |
Ciprofloxacin | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | N/A |
Pseudomonas aeruginosa | ||||
ESBL | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | N/A |
Ciprofloxacin | 0 (0.0%) | 0 (0.0%) | 2 (0.9%) | 0.082 |
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Kim, D.; Assiri, A.M.; Kim, J.H. Recent Trends in Bacteriology of Adult Patients with Chronic Rhinosinusitis. J. Clin. Med. 2019, 8, 1889. https://doi.org/10.3390/jcm8111889
Kim D, Assiri AM, Kim JH. Recent Trends in Bacteriology of Adult Patients with Chronic Rhinosinusitis. Journal of Clinical Medicine. 2019; 8(11):1889. https://doi.org/10.3390/jcm8111889
Chicago/Turabian StyleKim, Doyeon, Abdullah M. Assiri, and Ji Heui Kim. 2019. "Recent Trends in Bacteriology of Adult Patients with Chronic Rhinosinusitis" Journal of Clinical Medicine 8, no. 11: 1889. https://doi.org/10.3390/jcm8111889
APA StyleKim, D., Assiri, A. M., & Kim, J. H. (2019). Recent Trends in Bacteriology of Adult Patients with Chronic Rhinosinusitis. Journal of Clinical Medicine, 8(11), 1889. https://doi.org/10.3390/jcm8111889