Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2011 Mar;144(3):457-62. doi: 10.1177/0194599810394302. Epub 2011 Feb 3.
Bacterial biofilms appear to contribute to chronic rhinosinusitis. However, the mechanism behind biofilm formation in chronic rhinosinusitis remains poorly defined. The aim of this study is to evaluate clinical factors that may be associated with bacterial biofilm formation in chronic rhinosinusitis.
Cross-sectional study.
Department of Otorhinolaryngology-Head and Neck Surgery at the Hospital of the University of Pennsylvania.
Five hundred eighteen patients with chronic rhinosinusitis were enrolled from 2007 to 2010. Samples were taken to evaluate for biofilm formation in vitro using a modified Calgary Biofilm Detection Assay. Clinical data were collected from chart review. Pearson's χ(2) and logistic regression were used for the analyses.
Of the patients, 108 (20.9%) showed biofilm formation in vitro. Bacterial biofilm formation in vitro was not significantly associated with polyps, allergy, Samter's triad, sleep apnea, smoking status, age, or gender. However, it was significantly associated with positive culture results (odds ratio [OR] = 3.13; 95% confidence interval [CI], 1.85-5.29; P < .001), prior sinus surgeries (1.93; 1.01-3.69; P = .046), and nasal steroid use in the month prior to sample collection (2.09; 1.07-4.08; P = .030). Polymicrobial cultures, Pseudomonas aeruginosa, and Staphylococcus aureus comprised most of the samples.
The results of this study suggest that the probability of bacterial biofilm formation is independent of many clinical factors considered to be risk factors for chronic rhinosinusitis. Further studies are needed to clarify the nature of the associations between prior sinus surgeries, nasal steroid use, and biofilm formation.
细菌生物膜似乎与慢性鼻-鼻窦炎有关。然而，慢性鼻-鼻窦炎生物膜形成的机制仍不清楚。本研究旨在评估可能与慢性鼻-鼻窦炎细菌生物膜形成相关的临床因素。
横断面研究。
宾夕法尼亚大学医院耳鼻喉科-头颈外科。
2007 年至 2010 年期间，共纳入 518 例慢性鼻-鼻窦炎患者。采用改良卡尔加里生物膜检测法评估体外生物膜形成情况，并从病历中收集临床数据。采用 Pearson χ(2)检验和逻辑回归进行分析。
在这些患者中，有 108 例（20.9%）在体外形成生物膜。体外细菌生物膜形成与息肉、过敏、Samter 三联征、睡眠呼吸暂停、吸烟状况、年龄或性别无显著相关性。然而，它与阳性培养结果显著相关（比值比[OR] = 3.13；95%置信区间[CI]，1.85-5.29；P <.001）、既往鼻窦手术（1.93；1.01-3.69；P =.046）和在样本采集前 1 个月内使用鼻内皮质类固醇（2.09；1.07-4.08；P =.030）显著相关。多微生物培养、铜绿假单胞菌和金黄色葡萄球菌构成了大多数样本。
本研究结果表明，细菌生物膜形成的概率与许多被认为是慢性鼻-鼻窦炎危险因素的临床因素无关。需要进一步研究来阐明既往鼻窦手术、鼻内皮质类固醇使用与生物膜形成之间关联的性质。
