Chronic rhinosinusitis with nasal polyps（CRSwNP） represents a prevalent inflammatory disorder, which is often accompanied by nasal congestion, mucopurulent discharge, olfactory dysfunction, dizziness, and headache. Staphylococcus aureus（SA）, a predominant opportunistic pathogen within the sinonasal microenvironment, has been implicated in modulating the pathogenesis and progression of CRSwNP through multifaceted mechanisms. The physiological activities of SA-dependent quorum-sensing system and biofilm in the nasal microenvironment, including interactions with host, fungi, viruses, and other bacteria, as well as the effects of important superantigens secreted by SA on the microenvironment and immune barrier, are briefly reviewed in this article. These insights provide theoretical foundations for elucidating CRSwNP mechanisms and advancing clinical therapeutic strategies.
Humans ; Sinusitis/microbiology* ; Nasal Polyps/microbiology* ; Staphylococcus aureus ; Chronic Disease ; Rhinitis/microbiology* ; Staphylococcal Infections/microbiology* ; Quorum Sensing ; Biofilms ; Rhinosinusitis

OBJECTIVE: To study the distribution and drug sensitivity test of bacteria of patients on chronic rhinosinusitis with or without nasal polyps. METHOD: The purulent discharges were collected from sinus of 175 patients with chronic rhinosinusitis with or without nasal polyps during endoscopic sinus surgery. The results of germiculture and drug sensitivity test were analyzed. RESULT: From 175 specimens, 118 (67%) showed positive results in germiculture. Among them, 79 strains of gram positive bacteria and 39 strains of gram negative bacteria were detected. Staphylococcus epidermidis, Staphylococcus aureus and Staphylococcus haemolyticus were the most common pathogens in gram positive bacteria. The most common pathogens of gram negative bacteria were P. Aeruginosa, Enterobacter aerogenes, Enterobacter cloacae. The sensitive antibiotic on gram positive bacteria were amikacin, Daptomycin, Linezolid, vancomycin, teicoplanin, amoxicillin and clavulanate potassium, cefuroxime, respectively. The sensitive antibiotics on Gram negative bacteria were amikacin, Cefoperazone/sulbactam and imipenem, ceftazidime ceftazidime, aztreonam, levofloxacin, respectively. CONCLUSION Bacterial infection was common happened in the sinus cavity of patients with chronic rhinosinusitis with or without nasal polyps. Gram positive bacteria were the main pathogenic bacteria and gram positive bacteria and gram negative bacteria have great differences in the sensitivity of antibiotics. For patients with chronic rhinosinusitis, the using of antibiotics should depend on the drug sensitivity test.
Bacterial Infections ; complications ; drug therapy ; Gram-Negative Bacteria ; drug effects ; Gram-Positive Bacteria ; drug effects ; Humans ; Microbial Sensitivity Tests ; Nasal Polyps ; microbiology ; Rhinitis ; microbiology ; Sinusitis ; microbiology

OBJECTIVE: To determine the distribution of bacteria in patients with chronic rhinosinusitis, and to compare the bacteriologic features in middle meatus specimens between patients with nasal polyps (CRSwNP) and patients without nasal polyps (CRSsNP). 
 METHODS: We retrospectively analyzed the positive rate and types of bacterial culture in middle meatus specimens from 40 controls, 65 patients with CRSwNP, and 72 patients of CRSsNP. The specimens from the middle meatus were obtained during endoscopic sinus surgery.
 RESULTS: The positive rates of bacteria for CRSwNP, CRSsNP and the controls 81.9%, 80.0% and 82.5%, respectively, with no significant difference among the 3 groups. The common aerobe bacteria found in the specimens was Coagulase-negative staphylococci, Staphylococcus aureus, Streptococcus and Corynebacterium. The common anaerobe was Fusobacterium. The positive rates for aerobic and anaerobic bacteria showed no significant differences among the 3 groups.
 CONCLUSION The distribution of bacteria in middle meatus specimens is not significantly different among CRSwNP, CRSsNP and the controls. Therefore, bacterial infection may not play a key role in the pathogenesis of CRS patients with and without nasal polyos.
Bacterial Infections ; diagnosis ; Case-Control Studies ; Chronic Disease ; Corynebacterium ; isolation & purification ; Endoscopy ; Fusobacterium ; isolation & purification ; Humans ; Nasal Polyps ; microbiology ; Retrospective Studies ; Rhinitis ; microbiology ; Sinusitis ; microbiology ; Staphylococcus aureus ; isolation & purification ; Streptococcus ; isolation & purification

BACKGROUNDBiofilms have given new insights to the understanding of pathogenesis of chronic rhinosinusitis (CRS). However, the link between biofilms formation and local inflammatory response remains poorly defined in CRS with nasal polys. The aim of this study was to determine the potential association of the presence of biofilms in the nasal mucosal tissues with clinical features in Chinese patients, which had CRS with nasal polyps (CRSwNP).

METHODSA total of 19 patients with CRSwNP and 12 patients with non-CRS were subjected to endoscopic surgery and their nasal mucosal tissue specimens were examined histologically and by scanning electron microscopy (SEM). Their demographic and clinical features were recorded.

RESULTSThirteen (68.4%) out of the 19 specimens from patients with CRSwNP, but none from control patients, were positive for biofilms that displayed typical characteristics of bacterial and fugal structures. The presence of biofilms in the nasal mucosal tissues was associated with significantly greater values of purulent nasal discharge and preoperative Lund-Kennedy scores, higher levels of serum total IgE and percentages of subjects with endoscopic surgery (ESS) history in patients with CRSwNP, and more severe inflammation in the nasal mucosal tissues of patients with CRSwNP.

CONCLUSIONOur study demonstrated the presence of biofilms in the nasal mucosal tissues of many patients, contributing to the understanding of the pathogenic process of CRSwNP in Chinese patients.

Adolescent ; Adult ; Biofilms ; Chronic Disease ; Female ; Humans ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Nasal Mucosa ; pathology ; Nasal Polyps ; etiology ; microbiology ; pathology ; Rhinitis ; etiology ; microbiology ; pathology ; Sinusitis ; etiology ; microbiology ; pathology

OBJECTIVE: To compare the bacteriologic features of anterior ethmoidal biopsy specimens between chronic rhinosinusitis without nasal polyps (CRSNP-), chronic rhinosinusitis with nasal polyps(CRSNP+) and control patients. METHOD: The biopsy specimens obtained during the nasal endoscopic surgery were cultured for aerobic and anaerobic bacteria. RESULT: One hundred and nineteen biopsy specimens were processed for homogenization and semiquantitatively bacterial culture of aerobe and anaerobe. Bacterial culture were positive in 104 specimens (total culture-positive rate was 87.4%). The positive rate of aerobe or facultative anaerobe culture were 86.5%, 85.7%, 90.0% in CRSNP- group, CRSNP+ group and control group, respectively. There were no significant differences between 3 groups (P > 0.05). Mixed growth of aerobe and anaerobe bacteria were mainly detected in the biopsy specimens and the positive rate were 78.4%, 81.0% and 85.0% in CRSNP- group, CRSNP+ group and control group. There were no significant differences in 3 groups (P > 0.05). The most common aerobe bacteria found in 3 groups were coagulase-negative staphylococci and corynebacterium species and there were no significant differences between 3 groups (P > 0.05). The positive rate of anaerobic bacteria culture were 78.4%,76.2% and 77.5% in 3 groups. There were no significant differences between the groups (P > 0.05). Propionibacterium and peptostreptococcus species were the most common anaerobes, and there were no significant differences between 3 groups (P > 0.05). CONCLUSION There are no significant differences in the bacteriologic features of ethmoidal biopsy specimens between CRSNP+, CRSNP- and control patients. Therefore, bacterial infection may not play a key role in the pathogenesis of nasal polyps in CRS patients.
Adolescent ; Adult ; Aged ; Biopsy ; Case-Control Studies ; Chronic Disease ; Ethmoid Sinus ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; complications ; microbiology ; Sinusitis ; complications ; microbiology ; Young Adult

OBJECTIVETo search the evidence for the presence of superantigen of Staphylococcus aureus enterotoxin (SE) in the pathogenesis of nasal polyposis.

METHODSIn a cohort of population composed of 42 cases who belonged to three groups: nasal polyposis, simple chronic rhinosinusitis (CRS), and control group without any rhinopathy, detecting the specific IgE against SE-A and B (SEA and SEB), total IgE (TIgE), eosinophilic cationic protein (ECP) of the local mucosa by means of FRAST (UniCAP system), as well as the serum TIgE, and serum anti-SEA and SEB SIgE (only in 8 cases); meanwhile the secretion culture was performed for aerobic bacteria from the middle meatus.

RESULTSThere was no evidence to support that SE played as a superantigen in all mucosa samples (42 cases) and 8 cases serum samples out of the 42 patients. The range of TIgE in mucosa was 4.59 -70.21 kIU/2 mg tissue protein, the mean was (17.85 +/- 14.31) kIU/2 mg tissue protein; in serum the total IgE was 7.44 - 344.00 kIU/L, the mean was (88.65 +/- 80.03) kIU/L The positive culture of Staphylococcus aureus was obtained from only 3 cases from secretion of middle meatus (1 from nasal polyps, 2 from CRS). There was no significance statistically among the three groups on the tissue fluorescence value of SIgE for SE, the means of tissue TIgE and ECP.

CONCLUSIONSNo evidence was found to support the role of SE acting as a superantigen among our cases who did not have persistent asthma. It is suggested that further study and investigation is required to prove the superantigen Hypothesis in the pathogenesis of NPs.

Adolescent ; Adult ; Aged ; Antibodies, Bacterial ; blood ; Enterotoxins ; immunology ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Nasal Polyps ; immunology ; microbiology ; Sinusitis ; immunology ; microbiology ; Staphylococcus aureus ; immunology ; isolation & purification ; Superantigens ; blood ; Young Adult