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Sinus biofilms in patients with cystic fibrosis: is adjusted eradication therapy needed?

  • Rhinology
  • Published:
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Abstract

The paranasal sinuses can be a focus for colonisation of the cystic fibrosis (CF) lungs with pathogens. In the sinuses, bacteria can adapt to the lung environment and enhance their antibiotic resistance, with biofilm formation thought to be the most important adaptive mechanism, causing recalcitrant disease. The presence of biofilms in CF sinuses is sparsely described. In this descriptive cross-sectional study, the sinus mucosa from 16 CF patients were analysed by fluorescence in situ hybridization using specific peptide nucleic acid (PNA-FISH) probes for Pseudomonas aeruginosa and Staphylococcus aureus to demonstrate the presence of biofilms. Small clusters of biofilm were visualised lining the sinus mucosa of CF patients. Biofilms were found in 10 out of 18 cases; 7 with intermittent lung colonisation, 2 chronically infected, and one lung transplanted patient. Finding P. aeruginosa biofilms in intermittently lung-colonised patients encourage us to intensify the attempt to eradicate pathogenic bacteria from the CF sinuses in an early stage using combined antibiotic therapy in the prolonged exposure of the sinus-mucosal surface.

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Acknowledgments

The Novo Nordisk Foundation supported HKJ as a clinical research stipend. The Lundbeck Foundation supported SE by a grant to TB.

Conflict of interest

None reported.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet and Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Kasper Aanaes & Christian von Buchwald

  2. Institute of International Health, Immunology and Microbiology, The Faculty of Health Sciences, Panum Institute, The University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark

    Steffen Eickhardt, Niels Høiby & Thomas Bjarnsholt

  3. Department of Clinical Microbiology 9301, Rigshospitalet, Juliane Maries Vej 22, 2100, Copenhagen, Denmark

    Steffen Eickhardt, Helle Krogh Johansen, Niels Høiby & Thomas Bjarnsholt

  4. Paediatric Pulmonary Service Department of Paediatrics and Adolescent Medicine, Danish PCD and Child Centre, CF Centre Copenhagen, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Marianne Skov

  5. The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Hørsholm, Denmark

    Helle Krogh Johansen

Authors
  1. Kasper Aanaes
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  2. Steffen Eickhardt
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  4. Christian von Buchwald
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  6. Niels Høiby
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  7. Thomas Bjarnsholt
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Correspondence to Kasper Aanaes.

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Aanaes, K., Eickhardt, S., Johansen, H.K. et al. Sinus biofilms in patients with cystic fibrosis: is adjusted eradication therapy needed?. Eur Arch Otorhinolaryngol 272, 2291–2297 (2015). https://doi.org/10.1007/s00405-014-3322-x

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  • DOI: https://doi.org/10.1007/s00405-014-3322-x

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