title: Sinus microbiota varies among chronic rhinosinusitis phenotypes and predicts surgical outcome.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) is a prevalent multifactorial disease process in which bacteria are believed to play a role in the propagation of inflammation. Multiple subtypes of CRS have been described based on clinical and pathologic features, but a detailed examination of the sinus microbiota in patients with CRS and its clinical subtypes has yet to be performed.
  
  
  OBJECTIVE
  We sought to examine the resident microbiota of CRS subtypes and determine whether bacterial diversity is a predictor of disease outcomes.
  
  
  METHODS
  Sinus swabs from patients with CRS and healthy subjects collected during endoscopic sinus surgery were analyzed by means of molecular phylogenetic analysis of 16S rDNA pyrosequences.
  
  
  RESULTS
  Fifty-six patients with CRS and 26 control subjects were studied. Biodiversity was similar between the CRS and control groups. Among the CRS subtypes examined, only 2 conditions (presence of purulence and comorbid condition of asthma) were associated with significant alterations in microbial community composition. In 27 patients with CRS who were followed postoperatively, those with better outcomes had more diverse bacterial communities present at the time of surgery, along with higher relative abundances of Actinobacteria.
  
  
  CONCLUSIONS
  Analysis of microbiota in a large cohort reveals that particular CRS phenotypes (asthma and purulence) are characterized by distinct compositions of resident bacterial communities. We found that bacterial diversity and composition are predictors of surgical outcome, promoting the concept of community ecology in patients with CRS.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colo. Electronic address: vijay.ramakrishnan@ucdenver.edu.
authors.forename: Vijay R
authors.initials: VR
authors.lastname: Ramakrishnan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Leah J
authors.initials: LJ
authors.lastname: Hauser
authors.affiliation: Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Feazel
authors.affiliation: Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Diana
authors.initials: D
authors.lastname: Ir
authors.affiliation: Microbiome Research Consortium, University of Colorado School of Medicine, Aurora, Colo; Department of Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, Colo.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Robertson
authors.affiliation: Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colo; Microbiome Research Consortium, University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Frank
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D001419:Bacteria / Q000145:classification* / Q000187:drug effects / Q000235:genetics; D044822:Biodiversity; D016022:Case-Control Studies; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D020459:Genes, rRNA; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D064307:Microbiota / Q000187:drug effects / Q000235:genetics; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000187:drug effects / Q000276:immunology / Q000382:microbiology / Q000601:surgery*; D010641:Phenotype; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012220:Rhinitis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D012336:RNA, Ribosomal, 16S
keywords: 16S rDNA; 16S rRNA; Sinusitis; bacteria; chronic rhinosinusitis; microbiome; pyrosequencing; sinus surgery outcomes