title: Molecular characterization of the polymicrobial flora in chronic rhinosinusitis.
abstract: BACKGROUND
  Conventional cultures have implicated Staphylococcus aureus (SA) and coagulase-negative Staphylococcus (CNS) as principal pathogens in chronic rhinosinusitis (CRS). These results are questioned by recent studies in which molecular probes implicate Haemophilus influenzae instead.
  
  
  OBJECTIVE
  To identify all bacterial species present on sinonasal mucosa using molecular culture (bacterial tag-encoded FLX amplicon pyrosequencing [bTEFAP]) and to compare them with those identified with conventional methods.
  
  
  METHODS
  A prospective study of 18 patients undergoing endoscopic sinus surgery for CRS and 9 control patients with pituitary adenomas was conducted. Per-operative mucosal biopsies were assessed with bTEFAP by sequencing the species-specific 16S ribosomal deoxyribonucleic acid (DNA) fragment for genetic identification of bacteria and then compared with simultaneous swab culture.
  
  
  RESULTS
  Standard cultures showed mainly SA and CNS. Molecular cultures identified up to 20 organisms per sample. Surprisingly, anaerobic species predominated (Diaphorobacter and Peptoniphilus). SA was nevertheless detected in 50%.
  
  
  CONCLUSIONS
  Molecular cultures such as bTEFAP are sensitive tools for bacterial identification in CRS and suggest that anaerobe involvement may be more frequent than presumed.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Université de Montréal, Montreal, Quebec.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Stephenson
authors.forename: Leandra
authors.initials: L
authors.lastname: Mfuna
authors.forename: Scot E
authors.initials: SE
authors.lastname: Dowd
authors.forename: Randall D
authors.initials: RD
authors.lastname: Wolcott
authors.forename: Jean
authors.initials: J
authors.lastname: Barbeau
authors.forename: Michel
authors.initials: M
authors.lastname: Poisson
authors.forename: Garth
authors.initials: G
authors.lastname: James
authors.forename: Martin
authors.initials: M
authors.lastname: Desrosiers
mesh_terms: D001419:Bacteria / Q000145:classification*; D015373:Bacterial Typing Techniques; D018441:Biofilms; D001706:Biopsy; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*