Cargando…

Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy

The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis...

Descripción completa

Detalles Bibliográficos
Autores principales: Szaleniec, Joanna, Gibała, Agnieszka, Pobiega, Monika, Parasion, Sylwia, Składzień, Jacek, Stręk, Paweł, Gosiewski, Tomasz, Szaleniec, Maciej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963383/
https://www.ncbi.nlm.nih.gov/pubmed/31590369
http://dx.doi.org/10.3390/antibiotics8040175
_version_ 1783488265944301568
author Szaleniec, Joanna
Gibała, Agnieszka
Pobiega, Monika
Parasion, Sylwia
Składzień, Jacek
Stręk, Paweł
Gosiewski, Tomasz
Szaleniec, Maciej
author_facet Szaleniec, Joanna
Gibała, Agnieszka
Pobiega, Monika
Parasion, Sylwia
Składzień, Jacek
Stręk, Paweł
Gosiewski, Tomasz
Szaleniec, Maciej
author_sort Szaleniec, Joanna
collection PubMed
description The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis (ABRS), as our understanding of its microbiology is insufficient to establish specific treatment recommendations. Unfortunately, antibiotics frequently fail to control the symptoms of AECRS due to biofilm formation, disruption of the natural microbiota, and arising antibiotic resistance. These issues can potentially be addressed by phage therapy. In this study, the endoscopically-guided cultures were postoperatively obtained from 50 patients in order to explore the microbiology of AECRS, evaluate options for antibiotic treatment, and, most importantly, assess a possibility of efficient phage therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Haemophilus influenzae, Pseudomonas aeruginosa, and Enterobacteriaceae. Alarmingly, mechanisms of antibiotic resistance were detected in the isolates from 46% of the patients. Bacteria not sensitive to amoxicillin were carried by 28% of the patients. The lowest rates of resistance were noted for fluoroquinolones and aminoglycosides. Fortunately, 60% of the patients carried bacterial strains that were sensitive to bacteriophages from the Biophage Pharma collection and 81% of the antibiotic-resistant strains turned out to be sensitive to bacteriophages. The results showed that microbiology of AECRS is distinct from ABRS and amoxicillin should not be the antibiotic of first choice. Currently available bacteriophages could be used instead of antibiotics or as an adjunct to antibiotics in the majority of patients with AECRS.
format Online
Article
Text
id pubmed-6963383
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-69633832020-02-26 Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy Szaleniec, Joanna Gibała, Agnieszka Pobiega, Monika Parasion, Sylwia Składzień, Jacek Stręk, Paweł Gosiewski, Tomasz Szaleniec, Maciej Antibiotics (Basel) Article The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis (ABRS), as our understanding of its microbiology is insufficient to establish specific treatment recommendations. Unfortunately, antibiotics frequently fail to control the symptoms of AECRS due to biofilm formation, disruption of the natural microbiota, and arising antibiotic resistance. These issues can potentially be addressed by phage therapy. In this study, the endoscopically-guided cultures were postoperatively obtained from 50 patients in order to explore the microbiology of AECRS, evaluate options for antibiotic treatment, and, most importantly, assess a possibility of efficient phage therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Haemophilus influenzae, Pseudomonas aeruginosa, and Enterobacteriaceae. Alarmingly, mechanisms of antibiotic resistance were detected in the isolates from 46% of the patients. Bacteria not sensitive to amoxicillin were carried by 28% of the patients. The lowest rates of resistance were noted for fluoroquinolones and aminoglycosides. Fortunately, 60% of the patients carried bacterial strains that were sensitive to bacteriophages from the Biophage Pharma collection and 81% of the antibiotic-resistant strains turned out to be sensitive to bacteriophages. The results showed that microbiology of AECRS is distinct from ABRS and amoxicillin should not be the antibiotic of first choice. Currently available bacteriophages could be used instead of antibiotics or as an adjunct to antibiotics in the majority of patients with AECRS. MDPI 2019-10-05 /pmc/articles/PMC6963383/ /pubmed/31590369 http://dx.doi.org/10.3390/antibiotics8040175 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Szaleniec, Joanna
Gibała, Agnieszka
Pobiega, Monika
Parasion, Sylwia
Składzień, Jacek
Stręk, Paweł
Gosiewski, Tomasz
Szaleniec, Maciej
Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy
title Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy
title_full Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy
title_fullStr Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy
title_full_unstemmed Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy
title_short Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy
title_sort exacerbations of chronic rhinosinusitis—microbiology and perspectives of phage therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963383/
https://www.ncbi.nlm.nih.gov/pubmed/31590369
http://dx.doi.org/10.3390/antibiotics8040175
work_keys_str_mv AT szaleniecjoanna exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy
AT gibałaagnieszka exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy
AT pobiegamonika exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy
AT parasionsylwia exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy
AT składzienjacek exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy
AT strekpaweł exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy
AT gosiewskitomasz exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy
AT szaleniecmaciej exacerbationsofchronicrhinosinusitismicrobiologyandperspectivesofphagetherapy