Cohen Michael, Kofonow Jennifer, Nayak Jayakar V, Palmer James N, Chiu Alexander G, Leid Jeff G, Cohen Noam A
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA.
Am J Rhinol Allergy. 2009 May-Jun;23(3):255-60. doi: 10.2500/ajra.2009.23.3319.
Bacterial biofilms consist of a complex, organized community of bacteria that anchor to both biotic and abiotic surfaces. They are composed of layers of embedded, live bacteria within extruded exopolymeric matrix. This configuration allows for evasion of host defenses and decreased susceptibility to antibiotic therapy while maintaining the ability to deliberately release planktonic bacteria, resulting in recurrent acute infections. Thus, bacterial biofilms were hypothesized to contribute to the progression and persistence of chronic rhinosinusitis.
This review summarizes several of the seminal papers supporting this hypothesis.
Multiple reports using various imaging modalities have demonstrated the presence of biofilms in sinonasal mucosa of patients with chronic rhinosinusitis. More recently, several studies have correlated the presence of biofilms with poor clinical outcomes in the disease process. Early therapeutic interventions have generated mixed results.
Bacterial biofilms appear to contribute to the progression of chronic rhinosinusitis in a subset of patients, although substantial effort toward therapeutic intervention is still necessary.
细菌生物膜由附着在生物和非生物表面的复杂、有组织的细菌群落组成。它们由挤压出的胞外聚合物基质内的多层嵌入活细菌组成。这种结构允许逃避宿主防御并降低对抗生素治疗的敏感性，同时保持故意释放浮游细菌的能力，从而导致复发性急性感染。因此，有人推测细菌生物膜有助于慢性鼻窦炎的进展和持续存在。
本综述总结了支持这一假说的几篇开创性论文。
多项使用各种成像方式的报告表明，慢性鼻窦炎患者的鼻窦黏膜中存在生物膜。最近，几项研究将生物膜的存在与疾病过程中不良的临床结果相关联。早期治疗干预产生了混合结果。
细菌生物膜似乎在一部分患者中促进了慢性鼻窦炎的进展，尽管仍需要大力进行治疗干预。
