Prevalence and abundance of Staphylococcus aureus in the middle meatus of patients with chronic rhinosinusitis, nasal polyps, and asthma.
BACKGROUND
Chronic rhinosinusitis (CRS) is an idiosyncratic and multifactorial disease process. Bacteria play a role in some patients, by infection or stimulation of inflammation. Staphylococcus aureus (SA) appears to be implicated in a number of infectious and inflammatory mechanisms, and may be particularly relevant in CRS patients with nasal polyps and asthma.


METHODS
Middle meatus swabs from control and CRS patients collected during endoscopic sinus surgery were analyzed by quantitative polymerase chain reaction (QPCR). Total bacterial count, SA prevalence, and SA abundance were examined with respect to patient demographics and disease characteristics.


RESULTS
Total bacteria, as measured by QPCR, was not statistically different between controls, CRS without nasal polyps (CRSsNP), CRS with nasal polyps (CRSwNP), or CRS with asthma groups (p < 0.09). Total bacterial counts did not correlate with disease severity as measured by Lund-Mackay computed tomography (CT) scores (p = 0.65). The prevalence of SA was similar between groups (15-25%); however, the abundance increased in CRS patients with allergic rhinitis, nasal polyps, and asthma.


CONCLUSIONS
The paranasal sinuses are not sterile. SA is implicated in a subset of CRS patients with nasal polyps and/or asthma. Further study is required to predict this subset of patients, and to define the mechanisms of SA pathogenesis.
Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, CO 88045, USA. vijay.ramakrishnan@ucdenver.edu
Vijay R
VR
Ramakrishnan
Leah M
LM
Feazel
Leah J
LJ
Abrass
Daniel N
DN
Frank
D001249:Asthma / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D058491:Bacterial Load / Q000706:statistics & numerical data*; D002908:Chronic Disease; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D010256:Paranasal Sinuses / Q000382:microbiology* / Q000473:pathology; D015995:Prevalence; D012220:Rhinitis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D012852:Sinusitis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*
D004269:DNA, Bacterial