Document Detail


Demonstration of biofilm in human bacterial chronic rhinosinusitis.
MedLine Citation:
PMID:  16270598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bacterial biofilms may explain why some patients with bacterial chronic rhinosinusitis (CRS) improve while on antibiotics but relapse after completion of the antibiotic. In the human host, biofilms exist as a community of bacteria surrounded by a glycocalyx that is adherent to a foreign body or a mucosal surface with impaired host defense. Biofilms generate planktonic, nonadherent bacterial forms that may metastasize infection and generate systemic illness. These planktonic bacteria are susceptible to antibiotics, unlike the adherent biofilm. METHODS: We reviewed four cases of CRS using transmission electron microscopy (TEM) to assay for typical colony architecture of biofilms. Bacterial communities surrounded by a glycocalyx of inert cellular membrane materials consistent with a biofilm were shown in two patients. RESULTS: In the two patients without biofilm, a nonbacterial etiology was discovered (allergic fungal sinusitis) in one and in the other there was scant anaerobic growth on culture and the Gram stain was negative. Culture of the material from the biofilm grew Pseudomonas aeruginosa in both patients. Pseudomonas from the biofilm showed a glycocalyx, not present in Pseudomonas cultured for 72 hours on culture media. Both patients' symptoms with bacterial biofilms were refractory to culture-directed antibiotics, topical steroids, and nasal lavages. Surgery resulted in cure or significant improvement. CONCLUSION: Biofilms are refractory to antibiotics and often only cured by mechanical debridement. We believe this is the first TEM documentation of bacterial biofilms in CRS in humans.
Authors:
Berrylin J Ferguson; Donna B Stolz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of rhinology     Volume:  19     ISSN:  1050-6586     ISO Abbreviation:  Am J Rhinol     Publication Date:    2005 Sep-Oct
Date Detail:
Created Date:  2005-11-07     Completed Date:  2006-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807268     Medline TA:  Am J Rhinol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  452-7     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bacterial Infections / microbiology*,  pathology,  surgery
Biofilms / growth & development*
Biopsy
Chronic Disease
Female
Humans
Male
Maxillary Sinusitis / microbiology*,  pathology,  surgery
Microscopy, Electron, Scanning Transmission
Mucous Membrane / microbiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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