Kanodia Anupam, Monga Rabia, Ilyas Mohd, Verma Yash, Mohapatra Sarita, Rao Narayana Sudha, Vyas Meenal, Sikka Kapil, Atmakuri Krishnamohan
Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi, 110029 India.
Bacterial Pathogenesis Group, Infectious Diseases and Immunology Group, Translational Health Sciences and Technology Institute, Faridabad, Haryana 121001 India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3307-3318. doi: 10.1007/s12070-024-04678-9. Epub 2024 Apr 24.
Cholesteatoma usually harbors a poly-microbial infection. As the diversity of bacterial pathogens in the Indian COM is unknown, we set out to identify the bacteria associated with cholesteatoma disease in different patients of North India using targeted metagenomic analysis of the 16 S rRNA gene.
We recruited 15 patients of cholesteatomatous chronic otitis media (COM), who underwent surgical disease clearance. We divided these patients into four groups based on the four clinic-radiological stages categorized as per the EAONO/JOS joint consensus statement classification. Representative samples were extracted during the surgery and sent for bacterial culture and sensitivity and 16 S rRNA gene metagenomic analysis.
While 12 (80%) of the patients belonged to clinical Stage I/II; one patient had an extracranial complication (stage III) and two patients had an intracranial complication (stage IV). Our detailed bacterial metagenomics analyses showed that while phylum Proteobacteria was most abundant (reads up to ∼ 95%) in specimens from nine patients, phylum Firmicutes was most abundant (up to ∼ 80%) in specimens from four patients. Gamma (γ) Proteobacteria and Epsilon (ε) Proteobacteria were the most abundant class amongst Proteobacteria. Class Tissierellia stood out as the most abundant Firmicutes (40-60%), followed by Clostridia (20%) and Bacilli (10%). There was negligible difference in the bacterial profiles across all four clinical stages.
Cholesteatoma is primarily associated with Proteobacteria and Firmicutes phyla, even in complicated disease. Further studies with a larger sample size are required to validate our findings.
The online version contains supplementary material available at 10.1007/s12070-024-04678-9.
胆脂瘤通常存在多种微生物感染。由于印度慢性化脓性中耳炎（COM）中细菌病原体的多样性尚不清楚，我们着手通过对16S rRNA基因进行靶向宏基因组分析，来鉴定印度北部不同患者中与胆脂瘤疾病相关的细菌。
我们招募了15例胆脂瘤型慢性化脓性中耳炎（COM）患者，这些患者均接受了手术疾病清除治疗。我们根据欧洲耳科学与神经耳科学学会/日本耳鼻咽喉科学会联合共识声明分类法将这些患者分为四个临床-放射学阶段组。手术过程中提取代表性样本，送去进行细菌培养及药敏试验以及16S rRNA基因宏基因组分析。
12例（80%）患者属于临床I/II期；1例患者有颅外并发症（III期），2例患者有颅内并发症（IV期）。我们详细的细菌宏基因组分析表明，虽然在9例患者的标本中变形菌门最为丰富（读数高达约95%），但在4例患者的标本中厚壁菌门最为丰富（高达约80%）。γ-变形菌纲和ε-变形菌纲是变形菌门中最丰富的纲。蒂氏菌纲是最丰富的厚壁菌门（40 - 60%），其次是梭菌纲（20%）和芽孢杆菌纲（10%）。在所有四个临床阶段的细菌谱中差异可忽略不计。
即使在复杂疾病中，胆脂瘤主要与变形菌门和厚壁菌门相关。需要进一步进行更大样本量的研究来验证我们的发现。
在线版本包含可在10.1007/s12070-024-04678-9获取的补充材料。
