Exploring the Sinus Microbiome in Chronic Sinusitis
Researchers at the University of Florida are among the first investigators to examine the clinical and microbiologic characteristics, risk factors and recalcitrance in patients with chronic rhinosinusitis who had Achromobacter or Serratia marcescens infection in the sinuses.
Jeb Justice, M.D., chief of the Division of Rhinology and Skull Base Surgery at the UF College of Medicine — part of UF Health, the Southeast’s most comprehensive academic health center — was an author of two groundbreaking studies that focused on these less commonly isolated, gram-negative organisms in chronic rhinosinusitis. The results of both studies were published in Otolaryngology Online in 2018. [ref]
“A great deal of research exists into more common bacteria in chronic rhinosinusitis, such as Staphylococcus aureus and Pseudomonas aeruginosa,” says Justice. “In our institution we saw patients with less common gram-negative organisms and sought to elucidate whether they were causing disease or were innocent bystanders.”
Serratia marcenens is a gram-negative facultative anaerobe classified as a member of enterobacteriacae that has been isolated in nosocomial infections. Achromobacter is an aerobic, motile, nonfermenting, gram-negative bacillus found around the world in water and soil, including swimming pools and well water, and in dialysis and chlorhexidine solutions.
According to Dr. Justice, until recently the microbiota underlying chronic rhinosinusitis have been poorly understood. UF is one of the few centers in the country using advanced gene sequencing and molecular diagnostic testing to identify less common bacteria. These newer techniques, which move beyond simple bacterial culture, have vastly improved our understanding of the diversity of the sinus microbiome.
“Chronic sinusitis is a disease that impacts over 30 million people in this country and there is no cure for it,” explains Justice. “Some of the best treatments of sinusitis can have significant long-term side effects for patients. As we work to better understand the microbiome and its alterations in each individual patient, our surgical techniques and comprehensive approach to the care of sinus patients allows us to provide culture-directed topical therapies that can improve patient quality of life while limiting the amount of systemic therapies they need. This can be a huge win for our patients."
UF is committed to furthering the base of knowledge about these pathogenic bacteria and their role in chronic rhinosinusitis.