title: The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection.
abstract: BACKGROUND
  Bacteria and fungi are believed to influence mucosal inflammation in chronic rhinosinusitis (CRS). However their presence and relationship to disease is debated. This study used multiple detection methods to compare microbial diversity and microbial abundance in healthy and diseased sinonasal mucosa. The utility of contemporary detection methods is also examined.
  
  
  METHODS
  Sinonasal mucosa was analyzed from 38 CRS and 6 controls. Bacterial and fungal analysis was performed using conventional culture, molecular diagnostics (polymerase chain reaction coupled with electrospray ionization time-of-flight mass spectrometry) and fluorescence in situ hybridization.
  
  
  RESULTS
  Microbes were detected in all samples, including controls, and were often polymicrobial. 33 different bacterial species were detected in CRS, 5 in control patients, with frequent recovery of anaerobes. Staphylococcus aureus and Propionibacterium acnes were the most common organisms in CRS and controls, respectively. Using a model organism, FISH had a sensitivity of 78%, and a specificity of 93%. Many species were detected in both CRS and controls however, microbial abundance was associated with disease manifestation.
  
  
  CONCLUSIONS
  This study highlights some cornerstones of microbial variations in healthy and diseased paranasal sinuses. Whilst the healthy sinus is clearly not sterile, it appears prevalence and abundance of organisms is critical in determining disease. Evidence from high-sensitivity techniques, limits the role of fungi in CRS to a small group of patients. Comparison with molecular analysis suggests that the detection threshold of FISH and culture is related to organism abundance and, furthermore, culture tends to select for rapidly growing organisms.
authors: Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia.
authors: Sam
authors: S
authors: Boase
authors: Andrew
authors: A
authors: Foreman
authors: Edward
authors: E
authors: Cleland
authors: Lorwai
authors: L
authors: Tan
authors: Rachel
authors: R
authors: Melton-Kreft
authors: Harshita
authors: H
authors: Pant
authors: Fen Z
authors: FZ
authors: Hu
authors: Garth D
authors: GD
authors: Ehrlich
authors: Peter-John
authors: PJ
authors: Wormald
mesh_terms: D000328:Adult; D001419:Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D018407:Bacterial Physiological Phenomena; D044822:Biodiversity; D018441:Biofilms / Q000254:growth & development*; D002908:Chronic Disease; D060085:Coinfection / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D054892:Metagenome; D008828:Microbiological Techniques / Q000379:methods; D008875:Middle Aged; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*
references: Am J Rhinol Allergy. 2009 Sep-Oct;23(5):549-52
references: 19807992
references: Laryngoscope. 2006 Jul;116(7):1121-6
references: 16826045
references: Ann Otol Rhinol Laryngol. 2008 Dec;117(12):902-8
references: 19140536
references: Appl Environ Microbiol. 1997 Apr;63(4):1326-31
references: 16535569
references: FEMS Immunol Med Microbiol. 2011 Mar;61(2):133-40
references: 21204998
references: Am J Rhinol Allergy. 2009 May-Jun;23(3):261-3
references: 19490798
references: Am J Rhinol Allergy. 2010 May-Jun;24(3):169-74
references: 20537281
references: Nature. 2000 May 11;405(6783):228-33
references: 10821283
references: Open Microbiol J. 2010 Mar 17;4:8-19
references: 20461221
references: Am J Rhinol Allergy. 2009 Nov-Dec;23(6):556-61
references: 19958600
references: Am J Rhinol Allergy. 2011 Jul-Aug;25(4):e133-40
references: 21819748
references: J Otolaryngol Head Neck Surg. 2010 Apr;39(2):182-7
references: 20211106
references: Nat Rev Immunol. 2004 Jun;4(6):478-85
references: 15173836
references: Curr Biol. 2010 Jul 13;20(13):1222-6
references: 20619820
references: Laryngoscope. 2010 Feb;120(2):427-31
references: 19950368
references: Antimicrob Agents Chemother. 1978 Dec;14(6):893-8
references: 742876
references: Curr Opin Otolaryngol Head Neck Surg. 2009 Feb;17(1):43-9
references: 19225305
references: Otolaryngol Head Neck Surg. 2008 May;138(5):641-7
references: 18439472
references: Laryngoscope. 2007 Jul;117(7):1302-6
references: 17603329
references: Antimicrob Agents Chemother. 2004 Jul;48(7):2659-64
references: 15215123
references: Eur Arch Otorhinolaryngol. 2008 Jun;265(6):651-5
references: 18026743
references: Anal Biochem. 2003 May 1;316(1):50-7
references: 12694726
references: Laryngoscope. 2001 Mar;111(3):399-403
references: 11224767
references: Am J Rhinol. 2005 Mar-Apr;19(2):125-9
references: 15921210
references: Nat Rev Microbiol. 2008 Jul;6(7):553-8
references: 18521073
references: Curr Opin Otolaryngol Head Neck Surg. 2011 Jun;19(3):199-203
references: 21358332
references: PLoS Pathog. 2008 Oct;4(10):e1000184
references: 18949036
references: J Clin Microbiol. 2004 Aug;42(8):3549-57
references: 15297496
references: Otolaryngol Head Neck Surg. 2006 Apr;134(4):581-5
references: 16564376
references: Mayo Clin Proc. 1999 Sep;74(9):877-84
references: 10488788
references: Science. 1999 May 21;284(5418):1318-22
references: 10334980
references: Physiol Rev. 2010 Jul;90(3):859-904
references: 20664075
references: Nat Rev Immunol. 2009 May;9(5):313-23
references: 19343057
references: Curr Opin Gastroenterol. 2010 Nov;26(6):564-71
references: 20871399
references: Laryngoscope. 2011 Jul;121(7):1578-83
references: 21647904
references: Laryngoscope. 2010 Aug;120(8):1701-6
references: 20641074
references: Recent Pat DNA Gene Seq. 2008;2(3):187-99
references: 19075956
references: Microbiol Rev. 1995 Mar;59(1):143-69
references: 7535888
references: Allergy. 2011 Nov;66(11):1449-56
references: 21834937
references: Otolaryngol Head Neck Surg. 2003 Sep;129(3 Suppl):S1-32
references: 12958561