Leah J Hauser1, Diana Ir2, Todd T Kingdom1, Charles E Robertson3,4,5, Daniel N Frank2,3, Vijay R Ramakrishnan1. 1. Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Boulder, CO. 2. Division of Infectious Diseases, University of Colorado, Boulder, CO. 3. The Microbiome Research Consortium, University of Colorado, Aurora, CO. 4. Department of Biostatistics and Informatics, University of Colorado, Boulder, CO. 5. Department of Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, CO.
Abstract
BACKGROUND: Endoscopic sinus surgery (ESS) enjoys high success rates, but repopulation with pathogenic bacteria is 1 of the hallmarks of poorer outcomes. There are many hypothesized sources of repopulating bacteria; however, this process remains largely unexplored. This study examined changes in the sinus microbiome after ESS and medical therapies to identify potential sources for postsurgical microbial repopulation. METHODS: Samples from the anterior nares, ethmoid sinus, and nasopharynx were taken at the time of surgery from 13 subjects undergoing ESS for chronic rhinosinusitis (CRS). Patients were treated postoperatively with 2 weeks of oral antibiotics and saline rinses. The ethmoid sinus was sampled at 2 and 6 weeks postoperatively; microbiota were characterized using quantitative polymerase chain reaction (qPCR) and 16S ribosomal RNA (rRNA) gene sequencing. The Morisita-Horn beta-diversity index (M-H) was used to compare similarity between samples. RESULTS: The bacterial burden of the ethmoid was higher 2 weeks postoperatively than 6 weeks postoperatively (p = 0.01). The 6-week samples most closely represented the anterior nares and ethmoid at surgery (M-H = 0.58 and 0.59, respectively), and were least similar to the nasopharynx (M-H = 0.28). Principal coordinates analysis (PCoA) plots illustrate that the ethmoid microbiota temporarily shifted after surgery and antibiotics but returned toward baseline in many subjects. CONCLUSION: Bacterial communities colonizing the ethmoid 6 weeks postoperatively were most similar to anterior nasal cavity and pretreatment sinus microbial profiles, indicating a high degree of resilience in the sinonasal microbiome of most subjects. Interestingly, surgery and postoperative antibiotic therapy does not appear to reduce bacterial burden, but rather, shifts the microbial consortia.
BACKGROUND: Endoscopic sinus surgery (ESS) enjoys high success rates, but repopulation with pathogenic bacteria is 1 of the hallmarks of poorer outcomes. There are many hypothesized sources of repopulating bacteria; however, this process remains largely unexplored. This study examined changes in the sinus microbiome after ESS and medical therapies to identify potential sources for postsurgical microbial repopulation. METHODS: Samples from the anterior nares, ethmoid sinus, and nasopharynx were taken at the time of surgery from 13 subjects undergoing ESS for chronic rhinosinusitis (CRS). Patients were treated postoperatively with 2 weeks of oral antibiotics and saline rinses. The ethmoid sinus was sampled at 2 and 6 weeks postoperatively; microbiota were characterized using quantitative polymerase chain reaction (qPCR) and 16S ribosomal RNA (rRNA) gene sequencing. The Morisita-Horn beta-diversity index (M-H) was used to compare similarity between samples. RESULTS: The bacterial burden of the ethmoid was higher 2 weeks postoperatively than 6 weeks postoperatively (p = 0.01). The 6-week samples most closely represented the anterior nares and ethmoid at surgery (M-H = 0.58 and 0.59, respectively), and were least similar to the nasopharynx (M-H = 0.28). Principal coordinates analysis (PCoA) plots illustrate that the ethmoid microbiota temporarily shifted after surgery and antibiotics but returned toward baseline in many subjects. CONCLUSION: Bacterial communities colonizing the ethmoid 6 weeks postoperatively were most similar to anterior nasal cavity and pretreatment sinus microbial profiles, indicating a high degree of resilience in the sinonasal microbiome of most subjects. Interestingly, surgery and postoperative antibiotic therapy does not appear to reduce bacterial burden, but rather, shifts the microbial consortia.
Authors: Elisabeth S Dorn; Barbara Tress; Jan S Suchodolski; Tariq Nisar; Prajesh Ravindran; Karin Weber; Katrin Hartmann; Bianka S Schulz Journal: PLoS One Date: 2017-06-29 Impact factor: 3.240
Authors: Elizabeth Copeland; Katherine Leonard; Richard Carney; Justin Kong; Martin Forer; Yuresh Naidoo; Brian G G Oliver; Justin R Seymour; Stephen Woodcock; Catherine M Burke; Nicholas W Stow Journal: Front Cell Infect Microbiol Date: 2018-02-28 Impact factor: 5.293
Authors: Francesco Antonio Salzano; Luigi Marino; Giovanni Salzano; Riccardo Maria Botta; Giovanni Cascone; Umberto D'Agostino Fiorenza; Carmine Selleri; Vincenzo Casolaro Journal: J Immunol Res Date: 2018-06-03 Impact factor: 4.818