Abstract
Recent research into the pathophysiology of chronic rhinosinusitis suggests an important role for biofilms. They can be detected in both healthy and diseased nasal mucosa. Several different methods of detecting biofilms have been described. This study investigates the presence of biofilm in a larger group of patients with chronic rhinosinusitis undergoing primary functional endoscopic surgery. Sixty-one patients with chronic rhinosinusitis and 25 controls, with septal deviation, were included from 2010 to 2012. Endonasal biopsies were harvested during surgery, snap frozen in isopentane, cooled on dry ice and stored at -80oC. The samples were prepared with Invitrogens’ BacLight LiveDead kit, and investigated with confocal scanning laser microscopy for the presence of biofilm. In the chronic rhinosinusitis group 55/61 were biofilm positive as opposed to 14/25 in the control group. The difference was highly significant. The odds ratio was 7.2. Patients with chronic rhinosinusitis have a highly significant increased point prevalence of biofilms compared to controls.
Highlights
Chronic rhinosinusitis (CRS) is increasingly viewed as an entity composed of several different subgroups of diseases
Patients with chronic rhinosinusitis have a highly significant increased point prevalence of biofilms compared to controls
The pathogenesis of CRS is still poorly understood, resulting in a lack of targeted therapy for these patients . [1,2,3] Recently, several authors reported the presence of bacterial biofilm in the sinonasal mucosa in a high percentage of patients with CRS as opposed to healthy controls, implicating biofilms in the development of CRS . [4,5,6] Biofilms in humans are recognized as the culprit behind a diverse array of chronic infectious diseases, including infectious endocarditis, osteomyelitis and dental caries . [7,8,9,10,11]
Summary
Chronic rhinosinusitis (CRS) is increasingly viewed as an entity composed of several different subgroups of diseases. [14] Bacteria exchange DNA, notably resistance factors to different antibiotics These factors contribute to the resilience of biofilms, making them hard to eradicate . The question arises whether these reported differences could be caused by methodological differences amongst the groups investigating biofilms and CRS? The primary goal of the present study was to determine the point prevalence of bacterial biofilms in our patients with CRS, after establishing a suitable methodology in a pilot study. Recent research into the pathophysiology of chronic rhinosinusitis suggests an important role for biofilms. They can be detected in both healthy and diseased nasal mucosa. This study investigates the presence of biofilm in a larger group of patients with chronic rhinosinusitis undergoing primary functional endoscopic surgery
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