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Relationship between bacterial biofilm and clinical features of patients with chronic rhinosinusitis

  • Rhinology
  • Published:
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Abstract

The purpose of this study was to investigate the incidence of bacterial biofilm (BBF) in patients with chronic rhinosinusitis (CRS) using confocal scanning laser microscopy (CSLM), and to assess the relationship between BBF and clinical features of CRS. This was a prospective observational study of the sinus mucosa of 27 CRS patients and 10 controls undergoing endoscopic sinus surgery (ESS). Clinical information was recorded preoperatively and sinus mucosal specimens were collected intraoperatively. We determined the existence of BBF with BacLight/CSLM detection, and proposed a BBF scoring system based on its morphologic features. Clinical parameters, including symptom score, endoscopy score, CT score and symptom duration, were compared between CRS patients with and without BBF, and among CRS patients with different BBF score. BBF was found in 16/27 (59.26%) CRS patients and none in 10 controls. SNOT-20 symptom score and individual symptoms including need to blow nose, cough and postnasal discharge were significantly more severe in CRS patients with BBF than those without. BBF score was better correlated than BBF existence with SNOT-20 score (r = 0.811, P < 0.001 vs. r = 0.604, P = 0.001), and correlated with both endoscopy score (r = 0.490, P = 0.009) and symptom duration (r = 0.487, P = 0.010), neither was correlated with BBF (P = 0.824; P = 0.263). BBF score is likely to guide anti-BBF therapy in CRS patients.

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References

  1. Rudmik L, Smith TL (2011) Quality of life in patients with chronic rhinosinusitis. Curr Allergy Asthma Rep 11(3):247–252

    Article  PubMed  Google Scholar 

  2. Wood AJ, Douglas RG (2010) Pathogenesis and treatment of chronic rhinosinusitis. Postgrad Med J 86(1016):359–364

    Article  PubMed  CAS  Google Scholar 

  3. Hekiert AM, Kofonow JM, Doghramji L et al (2009) Biofilms correlate with TH1 inflammation in the sinonasal tissue of patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg 141(4):448–453

    Article  PubMed  Google Scholar 

  4. Singhal D, Psaltis AJ, Foreman A et al (2010) The impact of biofilms on outcomes after endoscopic sinus surgery. Am J Rhinol Allergy 24(3):169–174

    Article  PubMed  Google Scholar 

  5. Hochstim CJ, Masood R, Rice DH (2010) Biofilm and persistent inflammation in endoscopic sinus surgery. Otolaryngol Head Neck Surg 143(5):697–698

    Article  PubMed  Google Scholar 

  6. Foreman A, Jervis-Bardy J, Wormald PJ (2011) Do biofilms contribute to the initiation and recalcitrance of chronic rhinosinusitis? Laryngoscope 121(5):1085–1091

    Article  PubMed  Google Scholar 

  7. Zhang Z, Kofonow JM, Finkelman BS et al (2011) Clinical factors associated with bacterial biofilm formation in chronic rhinosinusitis. Otolaryngol Head Neck Surg 144(3):457–462

    Article  PubMed  Google Scholar 

  8. Singhal D, Foreman A, Bardy JJ et al (2011) Staphylococcus aureus biofilms: nemesis of endoscopic sinus surgery. Laryngoscope. doi:10.1002/lary.21805

  9. Al-Mutairi D, Kilty SJ (2011) Bacterial biofilms and the pathophysiology of chronic rhinosinusitis. Curr Opin Allergy Clin Immunol 11(1):18–23

    Article  PubMed  Google Scholar 

  10. Flemming HC, Wingender J (2010) The biofilm matrix. Nat Rev Microbiol 8(9):623–633

    PubMed  CAS  Google Scholar 

  11. Potera C (1999) Forging a link between biofilms and disease. Science 283(5409):1837–1839

    Article  PubMed  CAS  Google Scholar 

  12. Perloff JR, Palmer JN (2004) Evidence of bacterial biofilms on frontal recess stents in patients with chronic rhinosinusitis. Am J Rhinol 18(6):377–380

    PubMed  Google Scholar 

  13. Sanclement JA, Webster P, Thomas J et al (2005) Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis. Laryngoscope 115(4):578–582

    Article  PubMed  Google Scholar 

  14. Psaltis AJ, Ha KR, Beule AG et al (2007) Confocal scanning laser microscopy evidence of biofilms in patients with chronic rhinosinusitis. Laryngoscope 117(7):1302–1306

    Article  PubMed  Google Scholar 

  15. Prince AA, Steiger JD, Khalid AN et al (2008) Prevalence of biofilm-forming bacteria in chronic rhinosinusitis. Am J Rhinol 22(3):239–245

    Article  PubMed  Google Scholar 

  16. Dworniczek E, Fraczek M, Seniuk A et al (2009) Bacterial biofilms in patients with chronic rhinosinusitis. Folia Microbiol (Praha) 54(6):559–562

    Article  CAS  Google Scholar 

  17. Bezerra TF, Padua FG, Ogawa AI et al (2009) Biofilm in chronic sinusitis with nasal polyps: pilot study. Braz J Otorhinolaryngol 75(6):788–793

    Article  PubMed  Google Scholar 

  18. Foreman A, Psaltis AJ, Tan LW et al (2009) Characterization of bacterial and fungal biofilms in chronic rhinosinusitis. Am J Rhinol Allergy 23(6):556–561

    Article  PubMed  Google Scholar 

  19. Hochstim CJ, Choi JY, Lowe D et al (2010) Biofilm detection with hematoxylin-eosin staining. Arch Otolaryngol Head Neck Surg 136(5):453–456

    Article  PubMed  Google Scholar 

  20. Zernotti ME, Angel Villegas N, Roques Revol M et al (2010) Evidence of bacterial biofilms in nasal polyposis. J Investig Allergol Clin Immunol 20(5):380–385

    PubMed  CAS  Google Scholar 

  21. Foreman A, Singhal D, Psaltis AJ et al (2010) Targeted imaging modality selection for bacterial biofilms in chronic rhinosinusitis. Laryngoscope 120(2):427–431

    PubMed  Google Scholar 

  22. Foreman A, Wormald PJ (2010) Different biofilms, different disease? A clinical outcomes study. Laryngoscope 120(8):1701–1706

    Article  PubMed  Google Scholar 

  23. You H, Zhuge P, Li D et al (2011) Factors affecting bacterial biofilm expression in chronic rhinosinusitis and the influences on prognosis. Am J Otolaryngol. doi:10.1016/j.amjoto.2010.1011.1017

  24. Keir J, Pedelty L, Swift AC (2011) Biofilms in chronic rhinosinusitis: systematic review and suggestions for future research. J Laryngol Otol 125(4):331–337

    Article  PubMed  CAS  Google Scholar 

  25. Tamashiro E, Antunes MB, Palmer JN et al (2009) Implications of bacterial biofilms in chronic rhinosinusitis. Braz J Infect Dis 13(3):232–235

    Article  PubMed  Google Scholar 

  26. Hunsaker DH, Leid JG (2008) The relationship of biofilms to chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 16(3):237–241

    Article  PubMed  Google Scholar 

  27. Suh JD, Cohen NA, Palmer JN (2010) Biofilms in chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 18(1):27–31

    Article  PubMed  Google Scholar 

  28. Biel MA (2010) Photodynamic therapy of bacterial and fungal biofilm infections. Methods Mol Biol 635:175–194

    Article  PubMed  CAS  Google Scholar 

  29. Young D, Morton R, Bartley J (2010) Therapeutic ultrasound as treatment for chronic rhinosinusitis: preliminary observations. J Laryngol Otol 124(5):495–499

    Article  PubMed  CAS  Google Scholar 

  30. Benninger MS, Ferguson BJ, Hadley JA et al (2003) Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 129(3 Suppl):S1–S32

    Article  PubMed  Google Scholar 

  31. Ryan WR, Ramachandra T, Hwang PH (2011) Correlations between symptoms, nasal endoscopy, and in-office computed tomography in post-surgical chronic rhinosinusitis patients. Laryngoscope 121(3):674–678

    Article  PubMed  Google Scholar 

  32. Sanderson AR, Leid JG, Hunsaker D (2006) Bacterial biofilms on the sinus mucosa of human subjects with chronic rhinosinusitis. Laryngoscope 116(7):1121–1126

    Article  PubMed  Google Scholar 

  33. Larson DA, Han JK (2011) Microbiology of sinusitis: does allergy or endoscopic sinus surgery affect the microbiologic flora? Curr Opin Otolaryngol Head Neck Surg 19(3):199–203

    Article  PubMed  Google Scholar 

  34. Hai PV, Lidstone C, Wallwork B (2010) The effect of endoscopic sinus surgery on bacterial biofilms in chronic rhinosinusitis. Otolaryngol Head Neck Surg 142(3 Suppl 1):S27–S32

    Article  PubMed  Google Scholar 

  35. May T, Ito A, Okabe S (2009) Induction of multidrug resistance mechanism in Escherichia coli biofilms by interplay between tetracycline and ampicillin resistance genes. Antimicrob Agents Chemother 53(11):4628–4639

    Article  PubMed  CAS  Google Scholar 

  36. Rosati R, Dellavia C, Colombo A et al (2009) Nasal base symmetry: a three dimensional anthropometric study. Minerva Stomatol 58(7–8):347–357

    PubMed  CAS  Google Scholar 

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Acknowledgments

We thank the patients in this study for their participation, Cui-di Da and Jie Tian (ENT Central Laboratory, AEENTH, Fudan University) for technical assistance, Prof. Jack J. Jiang (ENT Biomedical Engineering Center, University of Wisconsin, USA) for critical reading of the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, 200031, People’s Republic of China

    Han Li, Dehui Wang, Xicai Sun, Huapeng Yu & Jingjing Wang

  2. Research Center, Affiliated Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, People’s Republic of China

    Li Hu

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  1. Han Li
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  2. Dehui Wang
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  3. Xicai Sun
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  4. Li Hu
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Correspondence to Dehui Wang.

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Li, H., Wang, D., Sun, X. et al. Relationship between bacterial biofilm and clinical features of patients with chronic rhinosinusitis. Eur Arch Otorhinolaryngol 269, 155–163 (2012). https://doi.org/10.1007/s00405-011-1683-y

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  • DOI: https://doi.org/10.1007/s00405-011-1683-y

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