The Potential of High‐Throughput DNA Sequencing of the Paranasal Sinus Microbiome in Diagnosing Odontogenic Sinusitis (original) (raw)

Sinusitis of odontogenic origin microbiology

To study the microbiology of sinusitis associated with odontogenic origin. Methods: Aspirates of 20 acutely and 28 chronically infected maxillary sinuses that were associated with odontogenic infection were processed for aerobic and anaerobic bacteria. Results: A total of 66 isolates were recovered from the 20 cases of acute sinusitis (3.3/specimen), 16 aerobic and facultatives, and 50 anaerobic. Aerobes alone were recovered in 2 (10%) specimens, anaerobes only in 10 (50%), and mixed aerobic and anaerobic bacteria in 8 (40%). The predominant aerobic were ␣-hemolytic streptococci (5), microaerophilic streptococci (4), and Staphylococcus aureus (2). The predominant anaerobes were anaerobic Gram-negative bacilli (22), Peptostreptococcus (12), and Fusobacterium spp. (9). A total of 98 isolates were recovered from the 28 cases of chronic sinusitis (3.5/patient): 21 aerobic and facultatives and 77 anaerobic. Aerobes were recovered in 3 (11%) instances, anaerobes only in 11 (39%), and mixed aerobic and anaerobic bacteria in 14 (50%). The predominant aerobes were ␣-hemolytic streptococci (7), microaerophilic streptococci (4), and S. aureus (5). The predominant anaerobes were Gram-negative bacilli (41), Peptostreptococcus (16), and Fusobacterium spp. (12). Thirteen ␤-lactamaseproducing bacteria (BLPB) were recovered from 10 (50%) patients with acute sinusitis and 25 BLPB from 21 (75%) patients with chronic sinusitis. No correlation was found between the predisposing odontogenic conditions and the microbiological findings. Conclusions: These data illustrate the similar microbiology of acute and chronic maxillary sinusitis associated with odontogenic infection where anaerobic bacteria predominate in both types of infections.

Odontogenic and rhinogenic chronic sinusitis: a modern microbiological comparison

International Forum of Allergy & Rhinology, 2015

Background: Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) play a relevant, o en underappreciated role in paranasal sinus infections. Treating SCDDT patients requires tailored medical and surgical approaches in order to achieve acceptable success rates. These approaches differ from common rhinogenic sinusitis treatment protocols mostly because of the different etiopathogenesis. Our study comprehensively evaluated microbiology and antibiotic resistance in SCDDT patients and compared findings with a control group of patients affected by rhinogenic sinusitis. Methods: We performed microbiological sampling during surgery on 28 patients with SCDDT and 16 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Colonies were isolated, Gram-stained, and the species identified using classic biochemical methods. These results were confirmed by DNA pyrosequencing, and then the resistance profile of each SCDDT isolate to various antibiotics was tested. Results: Microbial growth was observed in all SCDDT patients, whereas samples from 60% of patients in the control group failed to yield any bacterial growth (p < 0.001). Anaerobes grew in 14% of SCDDT patients as compared to 7% of CRSwNP patients (p = 0.42). Of the isolates from SCDDT patients, 70% were susceptible to amoxicillin/clavulanate, whereas all isolates were susceptible to levofloxacin, teicoplanin, and vancomycin. Of the staphylococci identified, 80% were capable of producing betalactamase. Conclusion: Given the extent of microbiological contamination within the maxillary sinus of SCDDT patients, these infections should be regarded as a different class of conditions from rhinogenic sinusitis. Our findings support the need for different approaches in the treatment of SCDDT patients.

Molecular analysis of bacterial flora associated with chronically inflamed maxillary sinuses

Journal of Medical Microbiology, 2003

Chronic maxillary sinusitis is a chronic inflammatory condition in which the role of microbial infection remains undefined. Bacteria have been isolated from chronically inflamed sinuses; however, their role in the chronicity of inflammation is unknown. The objective of this study was to determine whether bacteria are present in clinical samples from chronic maxillary sinusitis and to assess the diversity of the flora present. Washes and/or tissue samples from endoscopic sinus surgery on 11 patients with chronic maxillary sinusitis were subjected to PCR amplification of bacterial 16S rDNA using three universal primer pairs, followed by cloning and sequencing. The samples were also assessed for the presence of bacteria and fungi by conventional culture methods. Viable bacteria and/or bacterial 16S rDNA were detected from maxillary sinus samples of five of the 11 patients examined (45 %). Three sinus samples were positive by both PCR and culture methods, one was positive only by PCR, and one only by culture. Thirteen bacterial species were identified: Abiotrophia defectiva, Enterococcus avium, Eubacterium sp., Granulicatella elegans, Neisseria sp., Prevotella sp., Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, Stenotrophomonas maltophilia, Streptococcus gordonii, Streptococcus mitis/Streptococcus oralis and Streptococcus sp. Fungi were not detected. In one patient Streptococcus mitis/Streptococcus oralis, and in another patient Pseudomonas aeruginosa, were detected from both the sinus and the oral cavity using species-specific PCR primers. These results suggest that both aerobic and anaerobic bacteria can be detected in nearly half of chronic maxillary sinusitis cases. Journal of Medical Microbiology 52

Microbiological Study of Paranasal Sinusitis

International Journal of Current Microbiology and Applied Sciences, 2016

Acute Sinusitis is a common infection of the paranasal sinuses and Chronic Maxillary Sinusitis is one of the most common form. A total of 100 samples were collected from patients attending outpatient department of Oto-rhinolaryngology, Government General Hospital, Vijayawada, for Microbiological study. Highest incidence was seen in the age group of 21-30 years (60%). Out of 100 cases, 96(96%) were positive on culture of which 87(90.6%) were positive for bacterial culture, 1(1.04%) pure fungal and 8(8.33%) yielded mixed isolates. All the 11 cases of acute sinusitis were culture positive (100%) and 85(95.6%) of 89 cases with chronic sinusitis were positive for culture. The predominant organism from bacterial isolates was Coagulase Negative Staphyloccocus 32(40.50%) followed by Coagulase positive Staphylococcus 22(27.84%), Pneumococci 10(12.65%), Beta haemolytic Streptococci 5(6.32%) and others. The predominant bacterial isolate in Acute Sinusitis were Coagulase Negative Staphylococcus 6(54.54%) followed by Coagulase Positive Staphylococcus 2(18.18%), Diphtheroids 2(18.18%) and Klebsiella pneumoniae 1(9.09%). In chronic Sinusitis also the commonest isolate was CONS 33(35.86%) followed by Coagulase Positive Staphylococcus 24(26.08%), Pneumococci 12 (13.04%) and others. Allergic rhinitis was the commonest predisposing condition and Gentamycin is the drug of choice. Microorganisms causing sinusitis are mostly aerobic and facultatively anaerobic. Isolation and identification of the etiological agent and determination of its susceptibility pattern aids the clinician towards the proper management of the patient and helps in relieving the symptoms in a scientific way.

Sinus culture poorly predicts resident microbiota

International forum of allergy & rhinology, 2015

Chronic rhinosinusitis (CRS) is an inflammatory disorder of the paranasal sinuses in which bacteria are implicated. Culture-based assays are commonly used in clinical and research practice; however, culture conditions may not accurately detect the full range of microorganisms present in a sample. The objective of this study was to determine the accuracy of clinical culture of CRS specimens compared with DNA-based molecular techniques. Ethmoid samples from 54 CRS patients collected during endoscopic sinus surgery were analyzed by both clinical culture and 16S ribosomal RNA (rRNA) gene sequencing. The association between 16S relative abundance and detection by culture was determined using logistic regression. Each subject had an average of 3 isolates identified by bacterial culture and 21.5 ± 12.5 species identified by 16S sequencing. On average, 1.6 dominant taxa (>10% abundance) per subject were identified using molecular techniques, but only 47.7% of these taxa were identified b...

Microbiological analysis of paranasal sinuses in chronic sinusitis – A south Indian coastal study

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2013

Introduction: In contrast with the well established roles of microbes in the etiology of acute sinusitis, the exact roles of all of these microbes in the etiology of chronic sinusitis are uncertain. The objective of the study is to analyze micro-flora present in patients with chronic sinusitis in the coastal belt of India. Methods: A cross sectional study was done to analyze the microorganisms of paranasal sinuses in patients having chronic sinusitis undergoing a functional endoscopic sinus surgery. Biopsy/Swabs were taken from the infected sinus of the patients during surgery and were sent for microbiological analysis within 4 h of collection. Results: Staphylococcus aureus was the most common isolate accounting for 43% of the patients followed by Klebsiella spp., 9% and MRSA, 3%. Fungal organisms identified were Aspergillus and Candida spp. isolated from 9% of the patients, which is very high compared to the other studies. No anaerobes were isolated. Discussion: The possibility of a fungal infection should always be considered in the differential diagnosis of difficult to treat diseases of the paranasal sinuses especially in tropical coastal regions. Conclusion: Based on results we can vary the choice of antibiotics in chronic and acute rhinosinusitis leading to a better management of the condition.

Odontogenic Sinusitis: From Diagnosis to Treatment Possibilities—A Narrative Review of Recent Data

Diagnostics

The maxillary sinus is a structure at the border of specialties: otorhinolaryngology and maxillofacial surgery. Due to this fact, regarding etiology, it can be affected by both the rhinogenic and odontogenic path and can impose diagnostic difficulties. The etiopathogenic mechanisms that can affect the Schneiderian membrane are mainly inflammatory, iatrogenic, traumatic, and tumorous in nature. From a microbiological point of view, the bacteriology is polymorphic, including both aerobic and anaerobic species in acute OS, the predominating species in acute OS being aerobic, and in chronic anaerobic germs. The role of fungi in the determination of this pathology and in the production of the biofilm that leads to resistance to antibiotic treatment is also discussed. The present paper aims to present the etiopathogenesis, bacteriology, clinical manifestations, as well as treatment of odontogenic sinusitis (OS) from an updated perspective through reviewing the literature. If unilateral ma...

Diagnosing odontogenic sinusitis: An international multidisciplinary consensus statement

International Forum of Allergy & Rhinology, 2021

BackgroundOdontogenic sinusitis (ODS) is distinct from non‐odontogenic rhinosinusitis, and often requires multidisciplinary collaboration between otolaryngologists and dental providers to make the diagnosis. The purpose of this study was to develop international multidisciplinary consensus on diagnosing ODS.MethodsA modified Delphi method was used to assess for expert consensus on diagnosing bacterial ODS. A multidisciplinary panel of 17 authors with ODS expertise from 8 countries (8 otolaryngologists, 9 dental specialists) was assembled. Each author completed 2 of 3 surveys (2 specialty‐specific, and 1 for all authors). Thirty‐seven clinical statements were created, focusing on 4 important diagnostic components: suspecting ODS; confirming sinusitis in ODS; confirming different dental pathologies causing ODS; and multidisciplinary collaborative aspects of diagnosing ODS. Target audiences were all otolaryngologists and dental providers.ResultsOf the 37 clinical statements, 36 reached...

Bacteriologic findings in patients with chronic sinusitis

Ear, nose, & throat …, 2003

We studied the bacteriology of maxillary sinus aspirates obtained from patients diagnosed with chronic sinusitis. We recovered 659 strains from 510 aspirates; of these, 572 (86.8%) were aerobes and 87 (13.2%) were anaerobes. Aerobes only were recovered from 310 of ...

Chronic maxillary sinusitis: Clinical and microbiological evaluation

Journal of College of Medical Sciences-Nepal, 2012

Chronic sinusitis essentially results from untreated or inadequately treated acute sinusitis. Sinusitis is one of the common health problems worldwide. This is a prospective study, done in Department of ENT Bir Hospital Kathmandu. The study period was one year from 14 March 2009 to 15 March 2010. In this study the most commonly involved group is 21–30years (44%). The most presenting symptoms was Nasal discharge 46(92%) and nasal obstruction 44(88%). The most common sign was mucopus in nasal cavity in 44(88%) cases followed by post nasal drip in 39(78%) cases. The bacteria most frequently isolated from sinus aspirates were staphylococcus aureus 18(36%) and streptococcus pneumonia 16(32%). Majority of the aspirates 34(68%) cases yielded single organism. The antibiotic sensitivity testing showed that 48(96%) cases of isolates were sensitive to Cephalexin and ceftriaxone.Journal of College of Medical Sciences-Nepal, 2011, Vol-7, No-2, 17-22DOI: http://dx.doi.org/10.3126/jcmsn.v7i2.6675