title: Detection of Biofilms in Biopsies from Chronic Rhinosinusitis Patients: In Vitro Biofilm Forming Ability and Antimicrobial Susceptibility Testing in Biofilm Mode of Growth of Isolated Bacteria.
abstract: Chronic rhinosinusitis (CRS) is the most common illness among chronic disorders that remains poorly understood from a pathogenic standpoint and has a significant impact on patient quality of life, as well as healthcare costs. Despite being widespread, little is known about the etiology of the CRS. Recent evidence, showing the presence of biofilms within the paranasal sinuses, suggests a role for biofilm in the pathogenesis. To elucidate the role of biofilm in the pathogenesis of CRS, we assessed the presence of biofilm at the infection site and the ability of the aerobic flora isolated from CRS patients to form biofilm in vitro. For selected bacterial strains the susceptibility profiles to antibiotics in biofilm condition was also evaluated.Staphylococci represented the majority of the isolates obtained from the infection site, with S. epidermidis being the most frequently isolated species. Other isolates were represented by Enterobacteriaceae or by species present in the oral flora. Confocal laser scanning microscopy (CLSM) of the mucosal biopsies taken from patients with CRS revealed the presence of biofilm in the majority of the samples. Strains isolated from the specific infection site of the CRS patients were able to form biofilm in vitro at moderate or high levels, when tested in optimized conditions. No biofilm was observed by CLSM in the biopsies from control patients, although the same biopsies were positive for staphylococci in microbiological culture analysis. Drug-susceptibility tests demonstrated that the susceptibility profile of planktonic bacteria differs from that of sessile bacteria in biofilms.
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, Pisa, Italy. diluca.mariagrazia@gmail.com.|NEST, Istituto Nanoscienze-CNR and Scuola Normale Superiore, Pisa, Italy. diluca.mariagrazia@gmail.com.|Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin, Berlin, Germany. diluca.mariagrazia@gmail.com.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Di Luca
authors.affiliation: Department of Medical and Surgical Pathology, Otorhinolaryngology Unit, Pisa University Hospital, Pisa, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Navari
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, Pisa, Italy.|Microbiology Unit, Pisa University Hospital, Pisa, Italy.
authors.forename: Semih
authors.initials: S
authors.lastname: Esin
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, Pisa, Italy.|Microbiology Unit, Pisa University Hospital, Pisa, Italy.
authors.forename: Melissa
authors.initials: M
authors.lastname: Menichini
authors.affiliation: Microbiology Unit, Pisa University Hospital, Pisa, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Barnini
authors.affiliation: Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin, Berlin, Germany.|Center for Musculoskeletal Surgery, Septic Unit Charité-Universitätsmedizin, Berlin, Germany.
authors.forename: Andrej
authors.initials: A
authors.lastname: Trampuz
authors.affiliation: Department of Medical and Surgical Pathology, Otorhinolaryngology Unit, Pisa University Hospital, Pisa, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Casani
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, Pisa, Italy.|Microbiology Unit, Pisa University Hospital, Pisa, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Batoni
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D001706:Biopsy; D002908:Chronic Disease; D006801:Humans; D008826:Microbial Sensitivity Tests; D011788:Quality of Life; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification
chemical_list: D000890:Anti-Infective Agents
keywords: Adherent bacteria; Antibiotic resistance; Confocal fluorescence microscopy; Isothermal microcalorimetry; Sinus infection