Abstract
Chronic rhinosinusitis with chronic adenoiditis in children represents a global public health issue, seriously affecting the quality of parents and children life, because of its irritating symptoms like intermittent snoring, mouth breathing, dry mouth, nasal obstruction, headaches increased irritability and focus disorders on children. Bacterial biofilms are highly associated with the chronic infectious processes in children. Correct therapeutical management of this diagnostic combination is mandatory to improve the quality of one’s life. Objectives. The aim of the study is: to observe the ratio of adenoid mucosa covered with bacterial biofilm extracted from the nasopharynx of 50 paediatric patients suffering of chronic rhinosinusitis (RSC) and chronic adenoiditis (CA); and to point the fact that the adenoids contaminated with bacterial biofilm are a generator for chronic upper airway infections in children. Material and methods. We have measured using an image analysis program the bacterial biofilm covering the entire surface of the extracted adenoids mases, from 28 girls and 22 boys aged between 5 and 12 years diagnosed with CRS and CA. Control visits were performed to verify symptom improvement at 1, 3 and 6 months. Outcomes. Adenoids extracted from paediatric patients diagnosed with CRS and CA presented bacterial biofilms coverage on almost the entire mucosa (86.75%). Conclusions. Adenoid mases removed from paediatric patients with CSR and CA have most of their mucosal covered with bacterial biofilm. In the nasopharynx of paediatric patients with CSR and CA, bacterial biofilm can play the role of a constant fountain of infection. Adenoid mass removal explains the symptomatic improvement observed post operatory in the CRS with CA paediatric patients that do not respond to antibiotic therapy.
Highlights
Chronic rhinosinusitis (CRS) with chronic adenoiditis (CA) in paediatric patients represents a constant issue, with a great impact on the economy and on the quality of life
Chronic rhinosinusitis is more common in the paediatric population due to an increased frequency of exposure to upper respiratory tract infections in this group of patients
The same statement is made by Galli et al in a similar study: over 80% of the tissue specimens proved to be culture-positive and bacterial biofilm was observed in 65.6% of the tissue probes [16]
Summary
Chronic rhinosinusitis (CRS) with chronic adenoiditis (CA) in paediatric patients represents a constant issue, with a great impact on the economy and on the quality of life. The first-time bacterial biofilm was described in medical literature, was by Antonie van Leeuwenhoek (1632-1723) observing the dental plaque at the microscope [1]. The evolution of the bacteria as part of a biofilm presents 3 stages: stage 1 – the attachment, stage2 – the growth, and stage 3 – the detachment [2]. As the bacterial cells start to multiply, the exopolysaccharide structure is formed, and the biofilm starts making multiple towers and water channels through the matrix; these water channels play an important role regarding the waste disposal and help set the pH. Bacteria communicate in-between inside the biofilm structure, through chemical signalling called quorum sensing, mechanism that sets the bases for the antibiotic therapy resistance
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