Hakan Hamdi ÇELİK, Serdar ÖZER, Gamze ATAY, Metin ÖNERCİ, Oğuz ÖĞRETMENOĞLU, Ömer Taşkın YÜCEL, İlkan TATAR

Correlation of bacterial biofilm grade with clinical features in chronic rhinosinusitis

Amaç: Bu çalışmanın amacı, polip olmayan kronik rinosinüzit (KRS) hastalarında bakteriyel biyofilm varlığını taramalı elektron mikroskopu (TEM) ile göstermek ve biyofilm evresi ile hastaların klinik özellikleri arasında korelasyon olup olmadığını araştırmaktı. Yöntemler: Bu prospektif klinik çalışmada iki grup yer aldı: ilk grup endoskopik sinüs cerrahisi uygulanacak olan 20 KRS hastasından; kontrol grup ise KRSsi olmayan ve septoplasti ya da septorinoplasti cerrahisi uygulanacak olan 15 hastadan oluştu. Ameliyat öncesinde klinik bilgiler kaydedildi; cerrahi sırasında ise mukoza örnekleri ve kültür materyalleri elde edildi. Spesmenler biyofilm varlığı açısından TEM ile incelendi. Yüzeydeki biyofilm prevalansına göre, evre 0 ile 4 arasında biyofilm evrelemesi önerildi ve kullanıldı. Hastaların semptom skoru, alerji varlığı, önceki ESC öyküsü, bilgisayarlı tomografideki (BT) Lund-Mackay skoru ve kültür sonuçları ile biyofilm evresine göre karşılaştırıldı. Bulgular: Biyofilm varlığı KRS hastalarının 16/20 (%80)sında gözlenirken, kontrol gruptaki hiçbir hastada tespit edilmedi. KRS grubunda biyofilm varlığı mevcut olmayan hasta sayısının düşük olması (n=4) nedeniyle, bu grupta biyofilm olan ve olmayan hastaların birbiri ile istatistiksel karşılaştırması yapılmadı. Ancak yüksek biyofilm evresi (evre 3 ve 4) ile önceki ESC öyküsü ve kültür pozitifliği arasında bağlantı olabileceği, ameliyat öncesi semptom skoru, Lund-Mackay BT skoru ve alerji öyküsü ile ise korelasyon olmadığı izlenimine ulaşıldı. Sonuç: KRS patofizyolojisini daha iyi anlamak ve yeni tedavi hedefleri belirlemek için bir biyofilm evreleme sisteminin oluşturulması gerekmektedir.

Kronik rinosinüzitte bakteriyel biyofilm evresi ile klinik özelliklerin korelasyonu

Objective: The aim of this study was to determine the presence of bacterial biofilms in chronic rhinosinusitis (CRS) without polyps using scanning electron microscope (SEM) and to investigate whether there was correlation between grade of biofilm formation and clinical features of patients. Methods: This was a prospective observational study with two groups: the first group was composed of 20 CRS patients undergoing endoscopic sinus surgery (ESS) and the control group included 15 patients without CRS, undergoing septoplasty or septorhinoplasty surgery. Clinal data were recorded preoperatively; mucosal samples and culture materials were obtained intraoperatively. Specimens were investigated for detection of biofilms with SEM. A biofilm grading system from grade 0 to 4, according to biofilm prevalence on the surface, was proposed. Symptom score, allergy presence, previous ESS history, Lund-Mackay computed tomography (CT) score and culture results of patients were compared according to biofilm grade. Results: Biofilm formation was found in 16/20 (80%) CRS patients, yet none in 15 controls. Among CRS group, number of patients without biofilms (n=4) was too low to compare CRS patients with and without biofilms with each other, statistically. However, higher biofilm grades (grade 3 and 4) seemed to correlate with previous ESS and culture positivity but not with preoperative symptom score, Lund-Mackay CT score or allergy. Conclusion: A grading system for biofilms is essential and it should be established in order to perceive CRS pathophysiology and find new treatment targets.

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