Evidence of bacterial Biofilms in nasal polyposis

Introduction: the pathogeny of chronic rhinosinusitis with nasal polyposis (crs/np) has not been elucidated. bacterial exotoxins have been implicated in many infl ammatory chronic diseases,such as chronic otitis,chronic tonsillitis,cholesteatomas,and more recently crs/np. we propose that the bacteria in crs/np are not only present in a planktonic state,but also occur in microbial communities as biofilms. objective: to determine and characterize the presence of biofilms in crs/np. methods: we performed a prospective study in 12 patients undergoing endoscopic sinus surgery for nasal polyposis. ten patients without crs/np who underwent septoplasty were included as a control group. tissue samples were obtained from the inferior turbinate mucosae. the bacteria were isolated and typifi ed and the material was examined in vitro using a spectrophotometer,and in vivo using optical microscopy and confocal scanning laser microscopy. results: moderate to high in vitro biofilm-forming capacity was detected in 9 out of 12 patients with crs/np (mean [sd] optical density values of between 0.284 [0.017] and 3.337 [0.029]). the microorganisms isolated were staphylococcus (5 patients),streptococcus viridans,pseudomonas aeruginosa,enterococcus faecalis and streptococcus viridans/corynebacterium. biofilms were demonstrated in vivo in 2 patients and no biofilm structures were evident in any of the controls. conclusion: this study demonstrates the presence of bacterial biofilms in patients with crs/np. this chronic infl ammatory factor might contribute to nasal mucosa damage,increased infl ammatory cells in tissue,and the subsequent hyperplasic process. © 2010 esmon publicidad.