Recent Trends in Bacteriology of Adult Patients with Chronic Rhinosinusitis.

Doyeon Kim,Abdullah M Assiri,Ji Heui Kim

doi:10.3390/jcm8111889

Doyeon Kim, Abdullah M Assiri + Show 1 more

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https://doi.org/10.3390/jcm8111889

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Abstract

This study aimed to identify trends in bacteria isolated from Korean adults with chronic rhinosinusitis (CRS). Enrolled were CRS patients who underwent sinus bacterial culture during endoscopic sinus surgery between 2007–2008, 2011–2012, and 2017–2018 (n = 510). Patients’ clinical characteristics, bacterial culture results, and antibiotic resistance were reviewed. The bacteria isolation rate was 76.3% (73.9% for CRS with nasal polyps and 82.8% for CRS without nasal polyps; p = 0.038). In total, 650 strains were isolated, the most common was Coagulase Negative Staphylococci (CNS) (28.0%), followed by Streptococcus species (12.2%), Propionibacterium species (8.0%), Corynebacterium species (7.5%), Staphylococcus aureus (6.2%), Haemophilus species (5.7%), Klebsiella species (5.1%), and Pseudomonas aeruginosa (4.2%). Furthermore, an analysis of the bacterial trends in the three groups showed significant increases over time for the isolation of CNS (p = 0.006), Klebsiella (p = 0.002), and P. aeruginosa (p = 0.007) and extended-spectrum beta-lactamase (ESBL) producing Klebsiella (p < 0.001) and Enterobacter (p = 0.007) species in terms of antibiotics resistance. This study demonstrates that the frequency of CNS, Klebsiella, and P. aeruginosa in CRS patients and the ESBL-producing Klebsiella and Enterobacter species has significantly increased in CRS patients over the last decade.

Highlights

Chronic rhinosinusitis (CRS) is an inflammatory mucosal disease of the nasal cavity and paranasal sinuses that lasts more than 12 weeks
We found a high prevalence of Coagulase Negative Staphylococci (CNS) in both CRSsNP and CRS with nasal polyps (CRSwNP) patients with S. epidermidis presenting the majority of isolated CNS
In bacterial cultures obtained from the sinus during endoscopic sinus surgery (ESS), even though gram-positive bacteria were the most frequently isolated strains in patients with CRS, gram-negative bacteria such as Klebsiella species and P. aeruginosa showed a significantly increasing trend

Summary

Introduction

Chronic rhinosinusitis (CRS) is an inflammatory mucosal disease of the nasal cavity and paranasal sinuses that lasts more than 12 weeks. Microbiome studies have reported various organisms and their important roles in the pathophysiology of CRS [3], the selection of antibiotics for infectious exacerbations in CRS patients is recommended to follow the results of bacterial culture, ideally endoscopically guided culture [1,4]. Antibiotics for CRS in South Korea have been abused (e.g., by being prescribed in the absence of culture data), fueling concerns about the emergence of atypical bacterial strains and antibiotic-resistant strains. Such problems can contribute to an increased incidence of refractory CRS after endoscopic sinus surgery (ESS). A study of the recent bacteriological trends in CRS patients may contribute to the management of bacteriology after ESS

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