title: Next Generation Sequencing and the Microbiome of Chronic Rhinosinusitis: A Primer for Clinicians and Review of Current Research, Its Limitations, and Future Directions.
abstract: OBJECTIVE
  Microbiomics in chronic diseases, including chronic rhinosinusitis (CRS), have undergone rapid advances in recent times. The introduction of Next Generation Sequencing (NGS) technology has produced significant clinical insights regarding the bacteriology of these conditions. We review studies that have used 16S rRNA sequencing to specifically investigate the microbiota profiles of patients with CRS in a variety of contexts.
  
  
  METHODS
  Literature review using the CINAHL, MEDLINE, PUBMED, and the Cochrane databases. Papers utilizing 16S-sequencing technology on CRS specimens published between January 1, 1995, and October 31, 2015, were included. Studies limited to only healthy controls were excluded.
  
  
  RESULTS
  Consistent with published studies using non-NGS techniques, the main genera commonly identified from the sinuses of CRS patients included Staphylococcus, Propionibacterium, and Corynebacterium. The microbiome of CRS patients had lower bacterial diversity compared to controls in a number of studies. Also consistent with non-NGS-based studies, Staphylococcus was implicated as an important genus, with highly colonized patients having worse surgical outcomes. Conflicting reports of antibiotic effects on the CRS microbiome were observed. Sampling methods were well investigated, many of the studies reviewed failed to include important methodological detail.
  
  
  CONCLUSIONS
  While 16S sequencing is a novel microbiological laboratory method, current studies have confirmed our existing understanding of bacteriology of CRS without providing significant additional clinical insight. Complementing 16S studies with more complex NGS methods while developing robust clinical studies aimed at shifting the disrupted CRS microbiome will provide researches with the opportunity to derive further clinical insight and develop new therapeutic targets.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, South Australia.
authors.forename: Jake
authors.initials: J
authors.lastname: Jervis Bardy
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, South Australia alkis.psaltis@adelaide.edu.au.
authors.forename: Alkis J
authors.initials: AJ
authors.lastname: Psaltis
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003352:Corynebacterium / Q000235:genetics; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D064307:Microbiota / Q000235:genetics*; D009296:Nasal Cavity / Q000382:microbiology*; D010256:Paranasal Sinuses / Q000382:microbiology*; D011424:Propionibacterium / Q000235:genetics; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D012220:Rhinitis / Q000188:drug therapy / Q000382:microbiology*; D012852:Sinusitis / Q000188:drug therapy / Q000382:microbiology*; D013210:Staphylococcus / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S
keywords: 16S rRNA; 16S sequencing; chronic rhinosinusitis; metagenomics; microbiome; microbiota; pyrosequencing; review