title: Sinus biofilms in patients with cystic fibrosis: is adjusted eradication therapy needed?
abstract: The paranasal sinuses can be a focus for colonisation of the cystic fibrosis (CF) lungs with pathogens. In the sinuses, bacteria can adapt to the lung environment and enhance their antibiotic resistance, with biofilm formation thought to be the most important adaptive mechanism, causing recalcitrant disease. The presence of biofilms in CF sinuses is sparsely described. In this descriptive cross-sectional study, the sinus mucosa from 16 CF patients were analysed by fluorescence in situ hybridization using specific peptide nucleic acid (PNA-FISH) probes for Pseudomonas aeruginosa and Staphylococcus aureus to demonstrate the presence of biofilms. Small clusters of biofilm were visualised lining the sinus mucosa of CF patients. Biofilms were found in 10 out of 18 cases; 7 with intermittent lung colonisation, 2 chronically infected, and one lung transplanted patient. Finding P. aeruginosa biofilms in intermittently lung-colonised patients encourage us to intensify the attempt to eradicate pathogenic bacteria from the CF sinuses in an early stage using combined antibiotic therapy in the prolonged exposure of the sinus-mucosal surface.
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet and Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark, kasperaanaes@hotmail.com.
authors.forename: Kasper
authors.initials: K
authors.lastname: Aanaes
authors.forename: Steffen
authors.initials: S
authors.lastname: Eickhardt
authors.forename: Helle Krogh
authors.initials: HK
authors.lastname: Johansen
authors.forename: Christian
authors.initials: C
authors.lastname: von Buchwald
authors.forename: Marianne
authors.initials: M
authors.lastname: Skov
authors.forename: Niels
authors.initials: N
authors.lastname: Høiby
authors.forename: Thomas
authors.initials: T
authors.lastname: Bjarnsholt
mesh_terms: D000293:Adolescent; D000328:Adult; D018441:Biofilms; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology; D010256:Paranasal Sinuses / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000502:physiology*; D013211:Staphylococcus aureus / Q000502:physiology*; D055815:Young Adult