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

2012 ◽  
Vol 26 (6) ◽  
pp. 444-449 ◽  
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.

scholarly journals Moulds and Staphylococcus aureus enterotoxins are relevant allergens to affect Type 2 inflammation and clinical outcomes in chronic rhinosinusitis patients

2020 ◽  
Vol 6 (4) ◽  
pp. 00265-2020
Author(s):  
Yoshihiro Kanemitsu ◽  
Kensuke Fukumitsu ◽  
Ryota Kurokawa ◽  
Norihisa Takeda ◽  
Yoshiyuki Ozawa ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Outcomes ◽  
Chronic Rhinosinusitis ◽  
Specific Ige ◽  
Sinus Surgery ◽  
Tissue Samples ◽  
Asthmatic Patients ◽  
Staphylococcus Aureus Enterotoxins ◽  
Type 2 Inflammation

BackgroundSensitisation to moulds and Staphylococcus aureus enterotoxins (SEs) is associated with the pathophysiology of both asthma and chronic rhinosinusitis (CRS). The purpose of this study was to clarify the contribution of sensitisation to these allergens to Type 2 inflammation in the blood, nose and the lower airways, and clinical outcomes in CRS patients.MethodsWe prospectively enrolled 56 CRS patients who underwent endoscopic sinus surgery (ESS) (20 with comorbid asthma) and 28 healthy controls between October 2015 and December 2017. CRS patients were followed up for 12 months after surgery. Type 2 inflammation-related biomarkers were analysed using blood, resected tissue samples and sputum. 10 allergens including Alternaria, Aspergillus and SEs were measured. Type 2 inflammation-related biomarkers and clinical outcomes were compared in the stratification with the presence or absence of allergen sensitisation.ResultsSensitisation rate to moulds and SEs in asthmatic patients was increased when changing the cut-off value of specific IgE titre from 0.35 UA·mL−1 to 0.10 UA·mL−1 (1.7- and 4.5-fold, respectively). Moulds and SEs affected the prevalence of asthma and eosinophilic CRS by interacting with each other. All Type 2 inflammation-related biomarkers except for eosinophils in sinus tissue were significantly higher in patients with mould or SE (mould/SE) sensitisation (≥0.10 UA·mL−1) (n=19) than in those without (n=37) and healthy subjects (all p<0.05). Meanwhile, mould/SE sensitisation did not affect longitudinal changes in clinical outcomes after ESS. Changes in serum mould/SE-IgE levels after ESS remained unclear.ConclusionMould/SE sensitisation (≥0.10 UA·mL−1) may affect the development of Type 2 inflammation and clinical outcomes in CRS patients.

scholarly journals Rectal Staphylococcus aureus Carriage and Recurrence After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps: A Prospective Cohort Study

2021 ◽  
pp. 014556132110197
Author(s):  
Yue Peng ◽  
Zhao Liu ◽  
Zhijian Yu ◽  
Aiwu Lu ◽  
Tao Zhang
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Regression Model ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Prospective Cohort ◽  
Multivariate Regression ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Multivariate Regression Model

Objective: Chronic rhinosinusitis with nasal polyps (CRSwNPs) remains a major challenge due to its high recurrence rate after endoscopic sinus surgery (ESS). We aimed to investigate the risk factors of recurrence among patients who underwent ESS for Chronic rhinosinusitis (CRS). Methods: Prospective cohort study including 391 cases in a single institution receiving ESS were included for analysis from 2014 and 2017. Baseline characteristics including rectal Staphylococcus aureus ( S aureus) carriage in patients receiving ESS for CRSwNPs. The primary outcome was the recurrence of CRSwNPs. Multivariate regression model was established to identify independently predictive factors for recurrence. Results: Overall, 142 (36.3%) cases with recurrence within 2 years after ESS were observed in this study. After variable selection, multivariate regression model consisted of 4 variables including asthma (odds ratio [OR] = 3.41; P < .001), nonsteroidal anti-inflammatory drug allergy (OR = 2.27; P = .005), previous ESS (OR = 3.64; P < .001), and preoperative carriage of S aureus in rectum (OR = 2.34; P = .001). Conclusions: Based on our results, surgeons could predict certain groups of patients who are at high risk for recurrence after ESS. Rectal carriage of S aureus is more statistically related to the recurrence of CRSwNP after ESS compared with skin and nasal carriage.

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

2018 ◽  
Vol 8 (30) ◽  
pp. 87-94
Author(s):  
Iulia Sabaru ◽  
Codrut Sarafoleanu ◽  
Alina Maria Borcan
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Rhinosinusitis ◽  
Antibiotic Treatment ◽  
Pathogenic Bacteria ◽  
Geographic Area ◽  
Antibiotic Susceptibility Test ◽  
Study Results ◽  
Microbial Etiology ◽  
A Prospective Study ◽  
Resistance Rates

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.

scholarly journals Staphylococcus aureus on Sinus Culture Is Associated With Recurrence of Chronic Rhinosinusitis After Endoscopic Sinus Surgery

2018 ◽  
Vol 8 ◽  
Author(s):  
Anastasios Maniakas ◽  
Marc-Henri Asmar ◽  
Axel E. Renteria Flores ◽  
Smriti Nayan ◽  
Saud Alromaih ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery

scholarly journals Staphylococcus lentus Sinusitis: A New Sinonasal Pathogen

2019 ◽  
Vol 99 (6) ◽  
pp. NP62-NP63
Author(s):  
Casey Y. Hay ◽  
David A. Sherris
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Rhinosinusitis ◽  
Medical Records ◽  
Moraxella Catarrhalis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Human Pathogen ◽  
Haemophilus Influenza ◽  
Streptococcus Pneumonia ◽  
Acute Bacterial Rhinosinusitis

Background: The pathogens most commonly associated with acute bacterial rhinosinusitis include Streptococcus pneumonia, Haemophilus influenza, and Moraxella catarrhalis. The pathogens most commonly associated with chronic rhinosinusitis include Staphylococcus aureus and various anaerobic organisms, including Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus. This case report illustrates a case of chronic rhinosinusitis associated with the Staphylococcus lentus organism, a well-known animal pathogen that has never been documented in the sinonasal cavity before. Methods: The medical records of an adult patient who presented to the otolaryngology office were reviewed. The literature available was reviewed. Results: A 62-year-old man presented with chronic rhinosinusitis refractory to medical management. He was taken to the operating room for functional endoscopic sinus surgery and cultures were obtained, which returned positive for Staphylococcus lentus. He had no known animal contacts at home or work. He improved with surgery and appropriate antibiotic therapy. Conclusions: Staphylococcus lentus has never before been reported as a human pathogen in the sinonasal cavities. Otolaryngologists must routinely obtain cultures of mucus or tissue during sinus surgery in order to ensure appropriate antibiotic treatment after surgery and resolution of patient symptoms.

scholarly journals Evaluation of a Bioengineered Honey and Its Synthetic Equivalent as Novel Staphylococcus aureus Biofilm-Targeted Topical Therapies in Chronic Rhinosinusitis

2019 ◽  
Vol 34 (1) ◽  
pp. 80-86 ◽  
Author(s):  
Dionyssia Papadopoulou ◽  
Alicja Dabrowska ◽  
Philip G. Harries ◽  
Jeremy S. Webb ◽  
Raymond N. Allan ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Activity ◽  
Chronic Rhinosinusitis ◽  
In Vitro Study ◽  
Sinus Surgery ◽  
Bacterial Strains ◽  
Methicillin Resistant ◽  
Log Reduction ◽  
Lower Minimum Inhibitory Concentration

Background Chronic rhinosinusitis (CRS) is a common condition which affects the quality of life of millions of patients worldwide and has a significant impact on health-care resources. While Staphylococcus aureus bacterial biofilms play an important role in this disease, antimicrobial therapy is rarely effective and may promote antibiotic resistance. Thus, development of novel biofilm-targeting and antibiotic-sparing therapies is highly desirable and urgently required. Objective This in vitro study evaluated the antimicrobial activity of a novel synthetic honey-equivalent product which was designed to have the same reactive oxygen release profile as the engineered honey SurgihoneyRO™. Methods Treatment efficacy was investigated by assessment of planktonic growth, biofilm viability, thickness, and biomass using 12 CRS-related S. aureus mucosal bacterial strains. Results Both SurgihoneyRO™ and the synthetic honey-equivalent product inhibited growth of planktonic methicillin-resistant and methicillin-sensitive S. aureus strains, with the synthetic honey-equivalent product exhibiting a lower minimum inhibitory concentration. Treatment of established S. aureus biofilms reduced biofilm viability with 24-hour treatment resulting in a 2-log reduction in viability of biofilms formed by methicillin-resistant strains and a 1-log reduction in biofilms formed by methicillin-sensitive strains. Conclusions This preliminary study shows that the synthetic honey-equivalent product provides marked antimicrobial activity against S. aureus biofilms, with the potential for development in the clinical setting as an adjunctive biofilm-targeted therapy in CRS. The ultimate aim of such a product would be to reduce the need for antibiotics, steroids, and invasive surgical procedures in CRS patients as well as improving clinical outcomes following endoscopic sinus surgery.

scholarly journals Use of Confocal Microscopy To Analyze the Rate of Vancomycin Penetration through Staphylococcus aureus Biofilms

2005 ◽  
Vol 49 (6) ◽  
pp. 2467-2473 ◽  
Author(s):  
Kimberly K. Jefferson ◽  
Donald A. Goldmann ◽  
Gerald B. Pier
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Confocal Scanning Laser Microscopy ◽  
Planktonic Bacteria ◽  
Transcriptional Changes ◽  
Confocal Scanning ◽  
Biofilm Bacteria ◽  
Confocal Scanning Laser ◽  
Reduced Rate

ABSTRACT When bacteria assume the biofilm mode of growth, they can tolerate levels of antimicrobial agents 10 to 1,000 times higher than the MICs of genetically equivalent planktonic bacteria. The properties of biofilms that give rise to antibiotic resistance are only partially understood. Inhibition of antibiotic penetration into the biofilm may play a role, but this has not been proven directly. In this report, penetration of the glycopeptide antibiotic vancomycin into viable Staphylococcus aureus biofilms was analyzed by confocal scanning laser microscopy using a fluorescently labeled derivative of the drug. We found that while vancomycin bound to free-floating bacteria in water within 5 min, it took more than 1 h to bind to cells within the deepest layers of a biofilm. These results indicate that the antibiotic is transported through the depth of the biofilm but that the rate is significantly reduced with respect to its transport through flowing water. This suggests that, whereas planktonic bacteria were rapidly exposed to a full bolus of vancomycin, the bacteria in the deeper layers of the biofilm were exposed to a gradually increasing dose of the drug due to its reduced rate of penetration. This gradual exposure may allow the biofilm bacteria to undergo stress-induced metabolic or transcriptional changes that increase resistance to the antibiotic. We also investigated the role of poly-N-acetylglucosamine, an important component of the S. aureus biofilm matrix, and found that its production was not involved in the observed decrease in the rate of vancomycin penetration.

scholarly journals Bacterial biofilms in patients with chronic rhinosinusitis: a confocal scanning laser microscopy study

2014 ◽  
Vol 52 (2) ◽  
pp. 150-155
Author(s):  
K.A. Danielsen ◽  
O. Eskeland ◽  
K. Fridrich-Aas ◽  
V.C. Orszagh ◽  
G. Bachmann-Harildstad ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Microscopy Study ◽  
Scanning Laser ◽  
Confocal Scanning Laser Microscopy ◽  
Control Group ◽  
Laser Microscopy ◽  
Scanning Laser Microscopy ◽  
Confocal Scanning ◽  
The Difference ◽  
Confocal Scanning Laser

Background: 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. Methods: 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. Results: 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. Conclusion: Patients with chronic rhinosinusitis have a highly significant increased point prevalence of biofilms compared to controls.

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