The role of bacteria in chronic rhinosinusitis (CRS) is still debated and their effect on the lower airways is less known. The aim of this study was to identify the individual bacterial species in CRS and to correlate these microbiological data with the clinical findings and associated bacterial cultures of the lower airways. This prospective study included 25 CRS patients scheduled for functional endoscopic sinus surgery. Preoperatively, pulmonary function and CT examinations were performed together with endoscopic and clinical assessment. Under aseptic conditions, with the patient under general anesthesia, 25 bronchoalveolar lavages (BALs) via the endotracheal tube and 50 endoscopically guided middle meatal specimens were obtained. All the specimens were examined for aerobic and anaerobic bacteria and correlated to the associated neutrophilic cellular changes. Positive bacterial cultures were obtained in 71% of the middle meatal specimens and 8% of the BAL specimens. Three subgroups of lower airway involvement were identified, i.e. asthma, small airway disease (SAD) and normal lower airways. In SAD only, there was a significant correlation between the cultured bacteria of the left (p = 0.04) and the right (p = 0.04) middle meatus and the presence of local neutrophilia. In asthma, middle meatal bacterial cultures correlated with nasal blockage (p = 0.04) and CT Lund-Mackay score (p = 0.04). Conclusion: Middle meatal cultures were frequently positive, mainly aerobic Gram-positive bacteria. In SAD, a mixed flora of Gram-positive aerobic bacteria and anaerobic bacteria was observed that correlated with neutrophilic inflammation. BAL cultures do not show infection or colonization of the lower airways, despite functional abnormalities in 60% of the patients.

This content is only available via PDF.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.