Bacterial community of chronic rhinosinusitis patients and therapeutic ultrasound efficacy: clinical trial study
Background and Objectives: Bacterial involvement in chronic rhinosinusitis (CRS) condition made it difficult to treat using available antibiotic therapy. Therapeutic ultrasound was investigated here to evaluate bacterial diversity and quantity before and after continuous/pulsed ultrasound strategy compared to control patients.
Materials and Methods: Totally, 34 CRS patients were studied in three groups, including continuous ultrasound, pulsed ultrasound and control. Bacterial culture and identification were done before and after treatment. Computed tomography scan (CT scan) and questionnaire scores were recorded two times before and after intervention.
Results: The most prevalent bacterial isolates were non-hemolytic Streptococci (34 patients), coagulase-negative Staphylococcus (33 patients), Gram-negative cocci (26 patients), Staphylococcus aureus (19 patients), Streptococcus pneumoniae (five patients) and Streptococcus pyogenes (five patients). Both continuous and pulsed ultrasound could significantly reduce the quantity of bacterial isolates after treatment. CT scan and questionnaire results support the effectiveness of therapeutic ultrasound.
Conclusion: The quantity of clinically important bacteria was significantly reduced using ultrasound treatment and recovery of patients was supported by CT scan and questionnaire scores. Alternative therapeutic ultrasound could be an effective procedure in CRS patients.
2. Brook I. Microbiology of chronic rhinosinusitis. Eur J Clin Microbiol Infect Dis 2016; 35: 1059-1068.
3. Suh JD, Kennedy DW. Treatment options for chronic rhinosinusitis. Proc Am Thorac Soc 2011; 8: 132-140.
4. Bose S, Grammer LC, Peters AT. Infectious chronic rhinosinusitis. J Allergy Clin Immunol Pract 2016; 4: 584-589.
5. Boase S, Foreman A, Cleland E, Tan L, Melton-Kreft R, Pant H, et al. The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect Dis 2013; 13: 210.
6. Araujo E, Palombini BC, Cantarelli V, Pereira A, Mariante A. Microbiology of middle meatus in chronic rhinosinusitis. Am J Rhinol 2003; 17: 9-15.
7. Dunne WM Jr. Bacterial adhesion: seen any good biofilms lately? Clin Microbiol Rev 2002; 15: 155-166.
8. Bartley J, Ansari NN, Naghdi S. Therapeutic ultrasound as a treatment modality for chronic rhinosinusitis. Curr Infect Dis Rep 2014; 16: 398.
9. Young D, Morton R, Bartley J. Therapeutic ultrasound as treatment for chronic rhinosinusitis: preliminary observations. J Laryngol Otol 2010; 124: 495-499.
10. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015; 152(2 Suppl): S1-S39.
11. Brooks SG, Trope M, Blasetti M, Doghramji L, Parasher A, Glicksman JT, et al. Preoperative Lund-Mackay computed tomography score is associated with preoperative symptom severity and predicts quality-of-life outcome trajectories after sinus surgery. Int Forum Allergy Rhinol 2018; 8: 668-675.
12. Mahon CR, Lehman DC, Manuselis G (2014). Textbook of diagnostic microbiology. 5th ed. New York: Saunders.
13. Jett BD, Hatter KL, Huycke MM, Gilmore MS. Simplified agar plate method for quantifying viable bacteria. Biotechniques 1997; 23: 648-650.
14. Anderson M, Stokken J, Sanford T, Aurora R, Sindwani R. A systematic review of the sinonasal microbiome in chronic rhinosinusitis. Am J Rhinol Allergy 2016; 30: 161-166.
15. Feazel LM, Frank DN, Ramakrishnan VR. Update on bacterial detection methods in chronic rhinosinusitis: implications for clinicians and research scientists. Int Forum Allergy Rhinol 2011; 1: 451-459.
16. Stressmann FA, Rogers GB, Chan SW, Howarth PH, Harries PG, Bruce KD, et al. Characterization of bacterial community diversity in chronic rhinosinusitis infections using novel culture-independent techniques. Am J Rhinol Allergy 2011; 25(4): e133-e40.
17. Foreman A, Psaltis AJ, Tan LW, Wormald PJ. Characterization of bacterial and fungal biofilms in chronic rhinosinusitis. Am J Rhinol Allergy 2009; 23: 556-561.
18. Jervis-Bardy J, Foreman A, Field J, Wormald PJ. Impaired mucosal healing and infection associated with Staphylococcus aureus after endoscopic sinus surgery. Am J Rhinol Allergy 2009; 23: 549-552.
19. Health Protection Agency Investigation of sinus aspirate (2009). National Standard Method. BSOP 19 Issue 7.1. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/343935/B_19i7.3.pdf
20. Rombaux P, Gigi J, Hamoir M, Eloy P, Bertrand B. Bacteriology of chronic sinusitis: the bulla ethmoidalis content. Rhinology 2002; 40: 18-23.
21. Kim D, Assiri AM, Kim JH. Recent trends in bacteriology of adult patients with chronic rhinosinusitis. J Clin Med 2019; 8: 1889.
22. Boase S, Foreman A, Cleland E, Tan L, Melton-Kreft R, Pant H, Hu FZ, Ehrlich GD, Wormald PJ. The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect Dis 2013; 13: 210.
23. da Silva GS, Dos Santos Isoppo K. Therapeutic ultrasound as a treatment for chronic rhinosinusitis: A systematic review. Clin Respir J 2021; 15: 1275-1285.
24. Nakhostin-Ansari A, Nazem A, Ansari NN, Fathali M, Naghdi S, Hasson S. Effects of pulsed ultrasound on olfactory dysfunction in patients with chronic rhinosinusitis: A pilot study. Complement Ther Clin Pract 2021; 44: 101409.
25. Feizabadi N, Sarrafzadeh J, Fathali M, Vasaghi-Gharamaleki B, Dadgoo M, Kazemian H, et al. Quantitative analysis of Staphylococcus aureus in patients with chronic rhinosinusitis under continuous ultrasound treatment. Iran J Microbiol 2018; 10: 354-360.
26. Feizabadi N, Sarrafzadeh J, Fathali M, Vasaghi-Gharamaleki B, Dadgoo M, Kardan-Yamchi J, et al. The pulsed ultrasound strategy effectively decreases the S. aureus population of chronic rhinosinusitis patients. BMC Res Notes 2019; 12: 576.
|Issue||Vol 14 No 3 (2022)|
|Rhinosinusitis; Ultrasound therapy; Bacterial infection; Treatment; Computed tomography scan|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|