Evolution of microbial etiology in acute and chronic rhinosinusitis and its role in the current management of antibiotic treatment

Abstract BACKGROUND. Acute and chronic rhinosinusitis (CRS) are common conditions worldwide. In most cases, the etiology of acute rhinosinusitis (ARS) is viral, but there can be cases complicated by bacterial infection. The bacterial pathogens responsible for acute bacterial rhinosinusitis (ABRS) in most cases are Streptococcus pneumoniae, Haemophilus influenza and Moraxella catarrhalis. In recent years, some changes regarding this issue have been communicated. Also, the pathophysiology of CRS becomes a problem due to the increasing percentage of resistant or recurrent cases. OBJECTIVE. To identify the bacterial spectrum in patients diagnosed with ABRS and CRS and to establish the actual resistance rates of the most prescribed antibiotics for these affections in order to initiate the correct antibiotic treatment. MATERIAL AND METHODS. We performed a prospective study on 40 adult patients with ABRS and 70 patients with CRS. The standard microbiological procedures were performed in order to identify the involved microorganisms. The Antibiotic Susceptibility Test of the clinical isolates was performed to routinely used antibiotics according to EUCAST. RESULT. ABRS: A total of 21 types of pathogenic bacteria were isolated. The results indicated changes in the percentages of the traditionally involved bacteria, other species of streptococci and Staphylococcus aureus representing important pathogens. Almost half of the samples were polymicrobial. CRS: 12 bacteria were incriminated for CRS, Staphylococcus aureus and Pseudomonas aeruginosa being the most frequently identified pathogens. Regarding the antibiotic treatment, we established that in our country the resistance rates are higher than the ones communicated by WHO (especially for macrolides) and the fluoroquinolones seem to be the class with the highest safety profile. CONCLUSION. Study results demonstrate some changes of the bacteriologic spectrum in ABRS in this geographic area. The pathogens responsible for CRS are found in approximately the same percentage as presented in other studies. Antibiotic treatment demands attention considering the increasing trend of antibiotic resistance of the bacteria causing ABRS and CRS.

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Identifying Intracellular Staphylococcus Aureus in Chronic Rhinosinusitis: A Direct Comparison of Techniques

American Journal of Rhinology and Allergy ◽

10.2500/ajra.2012.26.3822 ◽

2012 ◽

Vol 26 (6) ◽

pp. 444-449 ◽

Cited By ~ 11

Author(s):

Neil C.-W. Tan ◽

Hai Bac Tran ◽

Andrew Foreman ◽

Camille Jardeleza ◽

Sarah Vreugde ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Chronic Rhinosinusitis ◽

Imaging Techniques ◽

Simultaneous Detection ◽

Sinus Surgery ◽

Confocal Scanning Laser Microscopy ◽

Tissue Samples ◽

Complementary Techniques ◽

Confocal Scanning Laser ◽

A Prospective Study

Background The emerging concept of intracellular pathogens such as Staphylococcus aureus playing a role in chronic rhinosinusitis (CRS) has led to the development of numerous imaging techniques for their identification. Traditional methods of bacterial culture are not effective at localizing bacteria to the surface or within tissue samples. The aim of this study was to develop and validate a novel imaging technique using confocal scanning laser microscopy (CSLM) coupled with a fluorescence in situ hybridization (FISH) probe and nucleic acid counterstain (propidium iodide [PI]) that allows for simultaneous analysis of S. aureus intracellular status and surface biofilm within whole mucosal samples. Methods A prospective study was performed including 17 patients undergoing endoscopic sinus surgery for CRS. Tissue samples were analyzed with both CSLM-FISH/PI and immunohistochemistry (IHC) for intracellular S. aureus status. Results Using CSLM-FISH/PI intracellular S. aureus was identified in 9/17 (47%) patients and in 7/17 (39%) using IHC. Surface biofilm can be identified with CSLM-FISH/PI in the same piece of tissue; however, deeper imaging to the submucosa is impossible. IHC showed submucosal bacteria in three patients. Conclusion Both CSLM-FISH/PI and IHC are complementary techniques that can be used to identify intracellular S. aureus. CSLM-FISH/PI allows for the simultaneous detection of intracellular status and surface biofilm within the tissue analyzed. IHC has a role in the identification of intracellular and submucosal S. aureus within these tissues. Additional investigation is required to identify the true pathogenic nature of intracellular organisms as well as any relationship to surface biofilm status.

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Adenoid Vegetations – Reservoir of Bacteria for Chronic Otitis Media with Effusion and Chronic Rhinosinusitis

PRILOZI ◽

10.1515/prilozi-2015-0080 ◽

2015 ◽

Vol 36 (3) ◽

pp. 71-76 ◽

Cited By ~ 3

Author(s):

Marina Davcheva-Chakar ◽

Ana Kaftandzhieva ◽

Beti Zafirovska

Keyword(s):

Staphylococcus Aureus ◽

Chronic Rhinosinusitis ◽

Otitis Media ◽

Pathogenic Bacteria ◽

Otitis Media With Effusion ◽

Pediatric Population ◽

Chronic Otitis Media ◽

Microbiological Analysis ◽

Adenoid Tissue ◽

Tissue Specimens

Abstract Introduction: Otitis media and rhinosinusitis are commonly encountered illnesses in pediatric population. Literature reports have documented the association between the occurrence of these two conditions and even their almost identical microbiological findings. Until recently, the key factor in the association of these two conditions was considered to be the hypertrophic adenoid tissue, but within the past few years there have been evidences in the literature about the presence of bacterial biofilms on the adenoids suggesting biofilms to be also responsible for both conditions, chronic otitis media with effusion and chronic rhinosinusitis. Aim: The aim of this study was to make a microbiological analysis of the adenoid tissue specimens taken from patients with chronic otitis media with effusion and chronic or recurrent rhinosinusitis and to determine their potential for biofilms formation. Methods: After the surgical intervention, adenoidectomy, microbiological evaluation and analysis of the adenoid tissue specimens taken from 20 patients were made. Having in mind the disease history, chronic otitis media with effusion was diagnosed in all 20 patients and chronic rhinosinusitis in 9 patients. Results: The results obtained from the microbiological analyses showed many potentially pathogenic bacteria in the adenoids that were almost identical with the most common organisms incorporated in the etiopathogenesis of both conditions, in chronic otitis media with effusion and in chronic rhinosinusitis. In 7 (35%) patients Haemophylus influenzae was isolated, in 6 (30%) Streptococcus pneumoniae, in 4 (20%) Moraxella catаrrhalis, in 2 (10%) patients Staphylococcus aureus and in 1 (5%) patient Streptococcus pyogenes - group A was isolated. One bacterium was isolated from all adenoid vegetations, except in one case when two bacteria (Haemophylus influenzae and Staphylococcus aureus) were concurrently isolated. Conclusion: Our results have shown that the key role in adenoid vegetations in chronic otitis media with effusion and chronic rhinosinusitis is not only the mechanism of rhinopharyngeal obstruction, but also the presence of bacterial strains with a large potential for formation of biofilms adhered to their surface, especially in cases with symptoms of chronic otitis media with effusion and chronic rhinosinusitis that were resistant to antibiotic therapy.

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Antibacterial Activity of Zingiber officinale (Ginger) against Clinical Bacterial Isolates

South Asian Journal of Research in Microbiology ◽

10.9734/sajrm/2019/v3i230080 ◽

2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Walla Fadel Mohammed ◽

Bushra Hindi Saleh ◽

Reem Naem Ibrahim ◽

Mohammed Bdaiwy Hassan

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Antibacterial Activity ◽

Pathogenic Bacteria ◽

Therapeutic Potential ◽

Morphological Characteristics ◽

Food Preservation ◽

Biochemical Tests ◽

Antibiotic Susceptibility Test

Aims: The objective of the present study was to investigate the phytochemical constituents and antibacterial activity of ginger extracts against some pathogenic bacteria responsible for Urinary tract infection. Study Design: A total of 35 samples were collected from patients with UTIs and wound infections. Place and Duration of Study: The study was conducted at 2 hospitals in Baghdad from1/7/2017 to 1/9/2017 Methodology: The urine sample was collected using a sterile container, while a swap from the infected wound was also taken. The classical methods for diagnosis pathogenic bacteria in urine and wound are based on culture on different microbiological media including. Blood agar, nutrient agar, then incubated at 37°C for 24 hrs. The diagnostic procedures consisted of direct microscopy observation, Gram staining, Biochemical tests, Catalase and coagulase tests. Results: Results show that 30.55%, 38.8%, 19.46% and 11.11% isolates gave typical morphological characteristics and biochemical test for Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonae and Staphylococcus aureus respectively. Antibiotic susceptibility test reveals that Escherichia coli isolates were 100% sensitive to gentamicin, tetracycline, streptomycine. Pseudomonas aeruginosa isolates reveal that 100% of them were sensitive to gentamicin, Imipenem, ampicillin and streptomycine. Staphylococcus aureus isolates reveal that 100% of them were sensitive to Gentamycine, tetracycline and streptomycine. Klebsiella pneumonae isolates reveal that 100% of them were sensitive to nitrofurantoin and Imipenem. Ginger roots extract at high concentration (250,500 mg/ml) have strong antibacterial activity against pathogenic bacteria (Staphylococcus aureus, Escherichia coli and Klebsiella pneumonae). Conclusion: This study has shown that ginger extracts possess medicinal properties, antibacterial activity and that the inhibition of bacterial growth was dose dependent. The results of the present study show that ginger extracts are more effective against all tested bacterial strains. The results of present study have provided the justification for therapeutic potential of ginger and also used as dietary supplement for food preservation.

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Microbial Diversity and Antibiotic Susceptibility Pattern of Bacteria Associated with Motorcycle Helmets

International Journal of Microbiology ◽

10.1155/2020/8877200 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Sanjeep Sapkota ◽

Sujan Khadka ◽

Sanjib Adhikari ◽

Ashish Parajuli ◽

Hemraj Kandel ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Microbial Diversity ◽

Antibiotic Susceptibility ◽

Pathogenic Bacteria ◽

Diffusion Method ◽

Beta Lactamase ◽

Bacterial Isolates ◽

Cross Sectional ◽

Antibiotic Susceptibility Test ◽

Motorcycle Helmets

Background. Motorcycle helmets can serve as a potential vehicle for the transmission of pathogenic bacteria and fungi with serious health implications. The main aim of this study was to explore the microbial diversity associated with the motorcycle helmets and determine the antibiotic susceptibility profile of the bacterial isolates. Methods. A descriptive cross-sectional study was carried out among the teaching staffs of Birendra Multiple Campus, Bharatpur, Nepal. A total of 130 motorcycle helmets worn by the teaching staffs of the Birendra Multiple Campus, Bharatpur, were included in the study for microbiological investigations. Results. Of the total 130 motorcycle helmets analyzed, 392 bacteria and 346 fungi belonging to seven different genera were recovered. Staphylococcus aureus 89 (22.7%) was the predominant bacteria followed by S. epidermidis 77 (19.6%) and E. coli 54 (13.8%), whereas Aspergillus niger 67 (19.4%) was the predominant fungi followed by A. fumigatus 49 (14.2%). Antibiotic susceptibility test was performed by the disc diffusion method for all the bacterial isolates. Tetracycline, gentamycin, and cotrimoxazole were the most effective antibiotics for Gram-positive isolates, whereas Gram-negative isolates were sensitive towards imipenem and ciprofloxacin. Of the total bacterial isolates, 153 (39.0%) were multidrug-resistant (MDR), 10.4% were extended-spectrum beta-lactamase (ESBL) producers, and 4.3% were metallo-beta-lactamase (MBL) producers and, out of 89 isolates of Staphylococcus aureus, 30 (33.7%) were detected as methicillin-resistant Staphylococcus aureus (MRSA). Conclusion. The findings suggest that motorcycle riders should follow good hygiene practices and regularly clean their helmets with suitable sterilants to avoid the risk of microbial contamination and reduce the associated risks.

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The microbiology and the efficacy of antibiotic-based medical treatment of chronic rhinosinusitis in Singapore

Rhinology Journal ◽

10.4193/rhino09.071 ◽

2010 ◽

Vol 48 (4) ◽

pp. 433-437

Author(s):

C.W.D. Chin ◽

C.L.S. Yeak ◽

D.Y. Wang

Keyword(s):

Staphylococcus Aureus ◽

Medical Treatment ◽

Chronic Rhinosinusitis ◽

Antibiotic Treatment ◽

Medical Therapy ◽

Nasal Polyps ◽

Bacterial Culture ◽

Sinus Surgery ◽

Prior Antibiotic Treatment

BACKGROUND: Medical therapy including appropriate antibiotic treatment is advocated for the management of chronic rhinosinusitis (CRS), with sinus surgery reserved for treatment failures. This study investigates the microbiology of CRS and their response to culture-directed antibiotic treatment. METHODS: Sinus aspirates of mucopus from 172 consecutive CRS patients, with (n=89) and without (n=83) previous antibiotic treatment, were obtained for bacterial culture at their first visit. Medical treatment which included initial empirical and subsequent culture-directed antibiotics was instituted. Endoscopic sinus surgery (FESS) was performed for patients with persistent CRS and/or complications of CRS. A follow-up of 12 months was scheduled for all patients. RESULTS: One hundred and twenty (69.8%) patients were treated successfully by with antibiotic-based medical therapy. Thirty-eight patients (22.1%) did not respond to medical treatment and eventually underwent FESS. The incidence of CRS with nasal polyps (CRSwNP) was higher in FESS group (n=13, 34.2%) than patients with medical treatment only (n=9, 6.7%). Staphylococcus aureus was the most common pathogen (n=43, 25%) and amongst patients with no prior antibiotic treatment, the incidence was higher in patients with CRSwNP (n=8, 53 %) than CRS without NP (CRSwoNP) (n=20, 27%). The rate of sensitivity of the cultured microbes to amoxicillin with clavulanate and cephalosporins was 78% and 70%, respectively. CONCLUSION: The microbiology of CRS in Singapore is described. Staphylococcus aureus appears to be the most common bacterial isolates in both CRS with and without nasal polyps. Medical treatment with CRS using culture-directed antibiotics is effective in the majority of patients, especially in patients without nasal polyps.

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Prevalence and antibiotic susceptibility of bacteria from acute and chronic wounds in Malaysian subjects

The Journal of Infection in Developing Countries ◽

10.3855/jidc.5882 ◽

2015 ◽

Vol 9 (09) ◽

pp. 936-944 ◽

Cited By ~ 21

Author(s):

Shin Yee Wong ◽

Rishya Manikam ◽

Sekaran Muniandy

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Susceptibility ◽

Pathogenic Bacteria ◽

Chronic Wounds ◽

Healing Process ◽

Antibiotic Sensitivity ◽

Microdilution Method ◽

Antibiotic Susceptibility Test ◽

Broth Microdilution Method ◽

Microbiological Techniques

Introduction: Chronic wounds represent a major health burden worldwide. It has been hypothesized that the polymicrobial nature of wounds plays an important role in their healing process. Thus, a review of pathogen frequency and susceptibility patterns in wounds is necessary to provide appropriate guidelines for antimicrobial usage. Methodology: In this study, microbiota and antimicrobial resistance in both acute and chronic wound patients treated at the University of Malaya Medical Centre, Malaysia, were compared. Wound swabs from 84 patients with acute wounds and 84 patients with chronic wounds were collected. The specimens were cultured using standard microbiological techniques. Isolates were then tested for antibiotic sensitivity with the broth microdilution method. Results: Of 210 pathogenic bacteria isolates, Staphylococcus aureus (49; 23.3%) and Pseudomonas aeruginosa (31; 14.8%) were the most prevalent bacteria found in wounds. Staphylococcus aureus was found significantly more often in patients with chronic wounds (41; 48.8%) than in patients with acute wounds (8; 9.5%), while Staphylococcus epidermidis was found predominantly in acute wounds (15; 17.9%). At the time of study, patients with chronic wounds (58.3%) had received more antibiotic treatments in the past previous 12 months compared with patients with acute wounds (16.7%). In the antibiotic susceptibility test, Staphylococcus spp. revealed highest resistance towards penicillin and ampicillin. Isolates showed no decrease in susceptibility against a number of newly developed antibiotics (linezolid, daptomycin, and tigecycline). Conclusions: Our finding showed that bacteria diversity and antimicrobial-resistant strains are more frequently found in chronic wounds than in acute wounds.

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The pulsed ultrasound strategy effectively decreases the S. aureus population of chronic rhinosinusitis patients

BMC Research Notes ◽

10.1186/s13104-019-4579-3 ◽

2019 ◽

Vol 12 (1) ◽

Author(s):

Narjes Feizabadi ◽

Javad Sarrafzadeh ◽

Mojtaba Fathali ◽

Behnoosh Vasaghi-Gharamaleki ◽

Mahdi Dadgoo ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Drug Resistance ◽

Chronic Rhinosinusitis ◽

Antibiotic Treatment ◽

Treatment Efficacy ◽

Biofilm Formation ◽

Alternative Therapy ◽

Healthy Controls ◽

Bacterial Cells ◽

Pulsed Ultrasound

Abstract Objective Staphylococcus aureus with the ability of biofilm formation and the drug resistance acquisition is one of the most frequently isolated pathogens from chronic rhinosinusitis patients. Ultrasound as an alternative therapy is effectively able to kill the bacteria by cavitation in or on the bacterial cells and peroxide generation and hence improving antibiotic treatment efficacy. Results Staphylococcus aureus was detected in 4 and 6 out of 14 patients by phenotypic and qPCR assays, respectively. Four patients were completely resolved after pulsed ultrasound treatment. However, presence of the S. aureus was confirmed in three healthy controls by bacterial cultivation. Pulsed ultrasound have been quantitatively decreased the S. aureus population in chronic rhinosinusitis patients (p < 0.05). Further studies need to be investigated the effectiveness of pulsed ultrasound as an alternative course of CRS patient’s treatment.

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Functional outcome after long-term low-dose trimethoprim/sulfamethoxazole in chronic rhinosinusitis with purulence: a prospective study

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000452 ◽

2018 ◽

Vol 132 (7) ◽

pp. 600-604 ◽

Cited By ~ 1

Author(s):

G de Bonnecaze ◽

B Chaput ◽

A Dupret-Bories ◽

S Vergez ◽

E Serrano

Keyword(s):

Staphylococcus Aureus ◽

Side Effects ◽

Prospective Study ◽

Chronic Rhinosinusitis ◽

Low Dose ◽

Tertiary Care ◽

Endoscopic Findings ◽

A Prospective Study ◽

Nasal Function

AbstractObjectiveTrimethoprim/sulfamethoxazole has been suggested as a treatment option for chronic rhinosinusitis with purulence. This study aimed to assess the functional and endoscopic outcomes after a three-month course of low-dose trimethoprim/sulfamethoxazole.MethodsA prospective study was performed, comprising patients referred to a tertiary care medical centre with a diagnosis of chronic rhinosinusitis with purulence. Trimethoprim/sulfamethoxazole was prescribed at 960 mg/day for three months. Sinonasal complaints and endoscopic findings were documented, and bacteriological data were compared.ResultsFifteen patients were included. Staphylococcus aureus was the most common bacterium cultured (86 per cent). Improvement in nasal function, as measured by the 22-item Sino-Nasal Outcome Test, was highly significant at three months (p < 0.0005). This improvement slightly decreased but remained significant at 6, 9 and 12 months. No side effects were noted. Endoscopic scores revealed similar and concordant improvements.ConclusionLong-term low-dose trimethoprim/sulfamethoxazole therapy seems to be a safe option for selected patients. Additional randomised multicentre studies remain necessary.

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