TY - JOUR
T1 - The effect of sinus surgery with intensive follow-up on pathogenic sinus bacteria in patients with cystic fibrosis
AU - Aanaes, Kasper
AU - von Buchwald, Christian
AU - Hjuler, Thomas
AU - Skov, Marianne
AU - Alanin, Mikkel
AU - Johansen, Helle Krogh
PY - 2013/1
Y1 - 2013/1
N2 - Background: Most patients with cystic fibrosis (CF) have chronic rhinosinusitis; their sinuses are often colonized with bacteria that can initiate and maintain deleterious pulmonary infections. Theoretically, eradication of the sinus bacteria should reduce the frequency of lung infections and thereby reduce pulmonary morbidity. This article addressed whether bacteria in CF sinuses are eligible for eradication by sinus surgery and postoperative treatment. Methods: A prospective study including 58 CF patients, who had extensive sinus surgery and growth of Pseudomonas aeruginosa, Achromobacter xylosoxidans, and/or Burkholderia multivorans in their sinuses, was initiated. All patients followed a systematic postoperative treatment program of nasal irrigations with saline and colistimethate sodium and systematic endoscopic cleansing. All patients had follow-up examinations including sinus cultures; each side of the nose was cultured separately. Results: At the 6-month follow-up visit, 49 patients were cultured; 66 of 98 maxillary- ethmoidal complexes (67%) showed no growth of pathogenic bacteria. Some patients were not free from CF pathogenic bacteria at all cultures; however, 20 (41%) patients had no bilateral regrowth (p < 0.01) and 4 patients had no unilateral regrowth at any time during 6 months of follow-up. The eradication of CF pathogens was accomplished in patients from all three lung infection groups: intermittently colonized, chronically infected, and lung transplanted. The patient with the longest follow-up had no bacterial growth for 3 years. Conclusion: Extensive sinus surgery combined with intensive follow-up can eradicate pathogenic bacteria from CF sinuses.
AB - Background: Most patients with cystic fibrosis (CF) have chronic rhinosinusitis; their sinuses are often colonized with bacteria that can initiate and maintain deleterious pulmonary infections. Theoretically, eradication of the sinus bacteria should reduce the frequency of lung infections and thereby reduce pulmonary morbidity. This article addressed whether bacteria in CF sinuses are eligible for eradication by sinus surgery and postoperative treatment. Methods: A prospective study including 58 CF patients, who had extensive sinus surgery and growth of Pseudomonas aeruginosa, Achromobacter xylosoxidans, and/or Burkholderia multivorans in their sinuses, was initiated. All patients followed a systematic postoperative treatment program of nasal irrigations with saline and colistimethate sodium and systematic endoscopic cleansing. All patients had follow-up examinations including sinus cultures; each side of the nose was cultured separately. Results: At the 6-month follow-up visit, 49 patients were cultured; 66 of 98 maxillary- ethmoidal complexes (67%) showed no growth of pathogenic bacteria. Some patients were not free from CF pathogenic bacteria at all cultures; however, 20 (41%) patients had no bilateral regrowth (p < 0.01) and 4 patients had no unilateral regrowth at any time during 6 months of follow-up. The eradication of CF pathogens was accomplished in patients from all three lung infection groups: intermittently colonized, chronically infected, and lung transplanted. The patient with the longest follow-up had no bacterial growth for 3 years. Conclusion: Extensive sinus surgery combined with intensive follow-up can eradicate pathogenic bacteria from CF sinuses.
U2 - 10.2500/ajra.2013.27.3829
DO - 10.2500/ajra.2013.27.3829
M3 - Journal article
C2 - 23406585
SN - 1945-8924
VL - 27
SP - e1-4
JO - American Journal of Rhinology & Allergy
JF - American Journal of Rhinology & Allergy
IS - 1
ER -