Microbial Diversity in Odontogenic Sinusitis: Next-Generation Sequencing Versus Culture

Area of Science:

• Microbiology
• Infectious Diseases
• Otolaryngology

Background:

• Odontogenic sinusitis (ODS) is a frequent cause of unilateral maxillary sinusitis, often underdiagnosed due to non-specific symptoms and limitations of standard bacterial cultures, especially for anaerobic organisms.
• Next-generation DNA sequencing (NGS) presents a potential advancement for detecting odontogenic bacteria, which are crucial in ODS pathogenesis.

Purpose of the Study:

• To compare the efficacy of standard bacterial cultures versus NGS in identifying microbial species within the maxillary sinuses of patients diagnosed with ODS.
• To evaluate the ability of NGS to detect anaerobic and ODS-related bacteria more comprehensively than conventional culture methods.

Main Methods:

• Twenty adult patients with confirmed ODS underwent endoscopic collection of maxillary sinus purulence.
• Specimens were analyzed using both routine aerobic/anaerobic bacterial cultures and 16S rRNA gene sequencing for NGS-based microbial profiling.
• Detected organisms were classified by aerotolerance and relevance to ODS, with nasal colonizers excluded; statistical analyses included diversity and compositional differences.

Main Results:

• NGS identified a significantly higher number of bacterial species per specimen compared to culture (mean 4.9 vs. 2.7, P=.0015).
• NGS revealed substantially more anaerobic bacteria (4.2 vs. 0.9, P=.00004) and ODS-related species (4.4 vs. 1.0, P=.0001) than cultures.
• While aerobic species detection was similar, NGS consistently showed polymicrobial communities dominated by oral anaerobes, unlike cultures which often yielded non-specific results.

Conclusions:

• In patients with confirmed ODS, NGS significantly outperforms standard culture in detecting anaerobic and ODS-associated bacterial species.
• Current culture-based methods may underestimate the role of odontogenic bacteria in the development and persistence of purulent sinusitis.
• NGS shows promise as an adjunctive diagnostic tool for ODS, potentially improving patient management and treatment strategies.