Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, CO 88045, USA.
Int Forum Allergy Rhinol. 2013 Apr;3(4):267-71. doi: 10.1002/alr.21101. Epub 2012 Oct 10.
Chronic rhinosinusitis (CRS) is an idiosyncratic and multifactorial disease process. Bacteria play a role in some patients, by infection or stimulation of inflammation. Staphylococcus aureus (SA) appears to be implicated in a number of infectious and inflammatory mechanisms, and may be particularly relevant in CRS patients with nasal polyps and asthma.
Middle meatus swabs from control and CRS patients collected during endoscopic sinus surgery were analyzed by quantitative polymerase chain reaction (QPCR). Total bacterial count, SA prevalence, and SA abundance were examined with respect to patient demographics and disease characteristics.
Total bacteria, as measured by QPCR, was not statistically different between controls, CRS without nasal polyps (CRSsNP), CRS with nasal polyps (CRSwNP), or CRS with asthma groups (p < 0.09). Total bacterial counts did not correlate with disease severity as measured by Lund-Mackay computed tomography (CT) scores (p = 0.65). The prevalence of SA was similar between groups (15-25%); however, the abundance increased in CRS patients with allergic rhinitis, nasal polyps, and asthma.
The paranasal sinuses are not sterile. SA is implicated in a subset of CRS patients with nasal polyps and/or asthma. Further study is required to predict this subset of patients, and to define the mechanisms of SA pathogenesis.
慢性鼻-鼻窦炎（CRS）是一种特发性和多因素的疾病过程。在一些患者中，细菌通过感染或炎症刺激发挥作用。金黄色葡萄球菌（SA）似乎与许多感染和炎症机制有关，并且在伴有鼻息肉和哮喘的 CRS 患者中可能特别相关。
通过定量聚合酶链反应（QPCR）分析内窥镜鼻窦手术中从对照和 CRS 患者中采集的中鼻甲拭子。根据患者的人口统计学和疾病特征，检查了总细菌计数、SA 的流行率和 SA 的丰度。
通过 QPCR 测量的总细菌在对照组、无鼻息肉的 CRS（CRSsNP）、有鼻息肉的 CRS（CRSwNP）或有哮喘的 CRS 组之间没有统计学差异（p<0.09）。总细菌计数与 Lund-Mackay 计算机断层扫描（CT）评分测量的疾病严重程度不相关（p=0.65）。SA 的流行率在各组之间相似（15-25%）；然而，在患有变应性鼻炎、鼻息肉和哮喘的 CRS 患者中，SA 的丰度增加。
鼻窦不是无菌的。SA 与伴有鼻息肉和/或哮喘的一部分 CRS 患者有关。需要进一步研究以预测这部分患者，并确定 SA 发病机制的机制。
