Barac Aleksandra, Pekmezovic Marina, Spiric Vesna Tomic, Trivic Aleksandar, Marinkovic Jelena, Pekic Sandra, Arsenijevic Valentina Arsic
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Dr Subotica 1, Belgrade, Serbia.
Clinic for Allergology and Immunology, Clinical Centre of Serbia, Belgrade, Serbia.
Eur Arch Otorhinolaryngol. 2015 Dec;272(12):3727-34. doi: 10.1007/s00405-015-3511-2. Epub 2015 Jan 29.
In recent years fungi are favoured as origin of chronic rhinosinusitis (CRS), especially with nasal polyps (wNP). Sensitive methods for fungal detection are still absent, therefore we used NP tissue single-cell suspension for mycology investigations in patients with recalcitrant NP (rNP) that underwent functional endoscopic sinus surgery (FESS). A prospective case-series study and culture-based mycological examination were conducted in patients who underwent FESS for the first time (ft-FESS) and those with repeated FESS (re-FESS). The study was conducted in a tertiary Otorhinolaryngology Unit of Clinical Centre of Serbia. A total of 43 consecutive patients with CRSwNP underwent FESS. Culture-based mycological examination of single-cell suspension was done on 55 NPs samples. Patient's co-morbidity data were collected. Repeated FESS was observed in 19/43 (44 %) patients (re-FESS group). Asthma and aspirin intolerance were more frequent in re-FESS than in ft-FESS group (p = 0.000, p = 0.002; respectively). Fungi were detected (wF) in 10/43 (23.3 %) patients (FESSwF group), representing 13/55 culture positive NP tissue (23.6 %). Fungal presence was higher in re-FESS than in ft-FESS group (42 and 8 %, respectively; p = 0.01). Significantly longer duration of CRS was observed in FESSwF than in fungal negative patients (p = 0.033). Predominate strain was Aspergillus flavus detected in 6/10 patients. This is the first study which analysed association of fungi in single-cell suspension of NP tissue and rNP. We demonstrate significantly higher percentage of positive fungal finding in re-FESSwF than in ft-FESSwF group. The most commonly isolated species in our patients was A. flavus.
近年来，真菌被认为是慢性鼻-鼻窦炎（CRS）尤其是伴鼻息肉（wNP）的病因。目前仍缺乏灵敏的真菌检测方法，因此我们将鼻息肉组织单细胞悬液用于接受功能性鼻内镜鼻窦手术（FESS）的难治性鼻息肉（rNP）患者的真菌学研究。对首次接受FESS（ft-FESS）和多次接受FESS（re-FESS）的患者进行了一项前瞻性病例系列研究及基于培养的真菌学检查。该研究在塞尔维亚临床中心的三级耳鼻咽喉科进行。共有43例连续性CRSwNP患者接受了FESS。对55份鼻息肉样本进行了基于培养的单细胞悬液真菌学检查。收集了患者的合并症数据。19/43（44%）例患者接受了多次FESS（re-FESS组）。与ft-FESS组相比，re-FESS组中哮喘和阿司匹林不耐受更为常见（分别为p = 0.000，p = 0.002）。10/43（23.3%）例患者检测到真菌（wF）（FESSwF组），占13/55份培养阳性的鼻息肉组织（23.6%）。re-FESS组中真菌检出率高于ft-FESS组（分别为42%和8%；p = 0.01）。FESSwF组CRS病程显著长于真菌阴性患者（p = 0.033）。主要菌株为黄曲霉，在6/10例患者中检测到。这是第一项分析鼻息肉组织单细胞悬液中的真菌与rNP之间关联的研究。我们发现re-FESSwF组真菌阳性检出率显著高于ft-FESSwF组。我们的患者中最常分离出的菌种是黄曲霉。
