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The role of infection in chronic rhinosinusitis
1Harvard Medical School, Division of Otolaryngology, Brigham and Women's Hospital, 333 Longwood Avenue, Boston, MA 02115, USA. neiloy@massmed.org
Abstract:
Chronic rhinosinusitis is a common condition, yet little is understood about its pathogenesis. Chronic infection traditionally has been considered a significant factor in the etiology and manifestations of chronic rhinosinusitis. Bacteria can be recovered in most cases of chronic rhinosinusitis, most commonly consisting of Staphylococcus species, anaerobes, and in some cases, gram-negative bacteria. Increasing trends toward bacterial resistance have been identified in chronic rhinosinusitis. Recently, a potential role for fungal infection has emerged. A knowledge of the microbiology of chronic rhinosinusitis will help guide treatment, but more research is required to understand further the exact role of infection in the pathophysiology of chronic rhinosinusitis.
Insights
Chronic rhinosinusitis pathogenesis is poorly understood, though chronic infection is a key factor. Research highlights bacterial resistance and emerging fungal roles in this common condition.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Chronic rhinosinusitis (CRS) is a prevalent condition with complex, incompletely understood pathogenesis.
- Historically, chronic infection has been a primary focus in understanding CRS etiology and clinical presentation.
- The role of microbial factors, including bacteria and fungi, is critical in CRS pathophysiology.
Purpose of the Study:
- To review the current understanding of microbial involvement in chronic rhinosinusitis.
- To highlight the prevalence of specific bacterial pathogens and emerging trends in antibiotic resistance.
- To discuss the potential contribution of fungal infections to CRS.
Main Methods:
- Literature review of studies investigating the microbiology of chronic rhinosinusitis.
- Analysis of bacterial species commonly isolated from CRS patients.
- Examination of trends in antimicrobial resistance patterns.
- Consideration of emerging evidence for fungal involvement.
Main Results:
- Bacteria, particularly Staphylococcus species, anaerobes, and Gram-negative bacteria, are frequently recovered from CRS cases.
- Increasing bacterial resistance poses a significant challenge in treating CRS.
- Fungal infections are increasingly recognized as a potential contributing factor.
Conclusions:
- Understanding the microbiology of chronic rhinosinusitis is essential for guiding effective treatment strategies.
- Further research is needed to elucidate the precise role of various infections in CRS pathophysiology.
- Addressing bacterial resistance and exploring fungal roles are key areas for future investigation.