Changes in the bacterial microbiome of patients with chronic rhinosinusitis after endoscopic sinus surgery
Ravi Jain MBChB
Department of Surgery, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorMichael Hoggard BSc (hons)
School of Biological Sciences, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorKristi Biswas PhD
Department of Surgery, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorMelissa Zoing MNurs
Department of Surgery, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorYannan Jiang PhD
Department of Statistics, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorCorresponding Author
Richard Douglas MD FRACS
Department of Surgery, The University of Auckland, Auckland, New Zealand
Correspondence to: Richard Douglas, MD FRACS, Department of Surgery, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; e-mail: [email protected]Search for more papers by this authorRavi Jain MBChB
Department of Surgery, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorMichael Hoggard BSc (hons)
School of Biological Sciences, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorKristi Biswas PhD
Department of Surgery, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorMelissa Zoing MNurs
Department of Surgery, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorYannan Jiang PhD
Department of Statistics, The University of Auckland, Auckland, New Zealand
Search for more papers by this authorCorresponding Author
Richard Douglas MD FRACS
Department of Surgery, The University of Auckland, Auckland, New Zealand
Correspondence to: Richard Douglas, MD FRACS, Department of Surgery, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; e-mail: [email protected]Search for more papers by this authorFunding sources for the study: Garnett Passe and Rodney Williams Foundation.
Potential conflict of interest: None provided.
Presented at the ARS Meeting at the annual Combined Otolaryngology Spring Meetings (COSM) on May 18–22, 2016, in Chicago, IL.
Abstract
Background
Endoscopic sinus surgery (ESS) improves symptoms for many chronic rhinosinusitis (CRS) patients by enlarging the size of sinus ostia, improving mucociliary clearance, and facilitating access for topical therapies. However, the effect of surgery on the sinonasal microbiota remains poorly understood. This study examined changes in bacterial communities in CRS patients before and after surgery.
Methods
Swab samples were taken from the middle meatus of 23 patients undergoing ESS. Follow-up swabs were taken in clinic (mean 120 days postsurgery). Symptom scores and antibiotic use were recorded. Bacterial communities were characterized using 16s ribosomal RNA (rRNA) gene-targeted amplicon sequencing and bacterial abundance was measured using quantitative polymerase chain reaction (PCR). Coexisting asthma, aspirin sensitivity, antibiotic use, and presence of polyps were controlled for.
Results
Unpredictable shifts in bacterial community composition were seen postoperatively. ESS was associated with increased bacterial richness. Many taxa had changes in average relative abundance and prevalence. Staphylococcus was the only dominant taxa to increase significantly in relative abundance (p = 0.002). Changes in bacterial communities were driven more by intersubject variability (p = 0.007) than other study factors. Finegoldia, a minority taxon, was associated with a reduction in abundance following ESS, increases in patients with higher symptoms scores, and reductions in patients with reduced total bacterial burden.
Conclusion
This study documented changes in bacterial composition and abundance in the middle meatus following ESS. The complexity of these changes reflects the variability between patients. Modern molecular techniques highlight the currently limited knowledge of the impact of therapies on the microbiology of CRS.
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