Targeted imaging modality selection for bacterial biofilms in chronic rhinosinusitis

2009 ◽  
Vol 120 (2) ◽  
pp. 427-431 ◽  
Author(s):  
Andrew Foreman ◽  
Deepti Singhal ◽  
Alkis J. Psaltis ◽  
Peter-John Wormald
Keyword(s):  
Chronic Rhinosinusitis ◽  
Imaging Modality ◽  
Bacterial Biofilms ◽  
Targeted Imaging ◽  
Selection For

Demonstration of Biofilm in Human Bacterial Chronic Rhinosinusitis

2005 ◽  
Vol 19 (5) ◽  
pp. 452-457 ◽  
Author(s):  
Berrylin J. Ferguson ◽  
Donna B. Stolz
Keyword(s):  
Chronic Rhinosinusitis ◽  
Culture Media ◽  
Cellular Membrane ◽  
Anaerobic Growth ◽  
Bacterial Biofilms ◽  
Topical Steroids ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Planktonic Bacteria ◽  
Transmission Electron

Background Bacterial biofilms may explain why some patients with bacterial chronic rhinosinusitis (CRS) improve while on antibiotics but relapse after completion of the antibiotic. In the human host, biofilms exist as a community of bacteria surrounded by a glycocalyx that is adherent to a foreign body or a mucosal surface with impaired host defense. Biofilms generate planktonic, nonadherent bacterial forms that may metastasize infection and generate systemic illness. These planktonic bacteria are susceptible to antibiotics, unlike the adherent biofilm. Methods We reviewed four cases of CRS using transmission electron microscopy (TEM) to assay for typical colony architecture of biofilms. Bacterial communities surrounded by a glycocalyx of inert cellular membrane materials consistent with a biofilm were shown in two patients. Results In the two patients without biofilm, a nonbacterial etiology was discovered (allergic fungal sinusitis) in one and in the other there was scant anaerobic growth on culture and the Gram stain was negative. Culture of the material from the biofilm grew Pseudomonas aeruginosa in both patients. Pseudomonas from the biofilm showed a glycocalyx, not present in Pseudomonas cultured for 72 hours on culture media. Both patients’ symptoms with bacterial biofilms were refractory to culture-directed antibiotics, topical steroids, and nasal lavages. Surgery resulted in cure or significant improvement. Conclusion Biofilms are refractory to antibiotics and often only cured by mechanical debridement. We believe this is the first TEM documentation of bacterial biofilms in CRS in humans.

P611 Bacterial biofilms in patients with chronic rhinosinusitis

2007 ◽  
Vol 29 ◽  
pp. S142-S143
Author(s):  
E. Dworniczek ◽  
M. Fraczek ◽  
J. Kassner ◽  
R. Adamski ◽  
A. Seniuk ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Bacterial Biofilms

Biofilms in Chronic Rhinosinusitis: A Review

2009 ◽  
Vol 23 (3) ◽  
pp. 255-260 ◽  
Author(s):  
Michael Cohen ◽  
Jennifer Kofonow ◽  
Jayakar V. Nayak ◽  
James N. Palmer ◽  
Alexander G. Chiu ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Disease Process ◽  
Therapeutic Interventions ◽  
Bacterial Biofilms ◽  
Planktonic Bacteria ◽  
Acute Infections ◽  
Abiotic Surfaces ◽  
Live Bacteria ◽  
Sinonasal Mucosa ◽  
Substantial Effort

Background Bacterial biofilms consist of a complex, organized community of bacteria that anchor to both biotic and abiotic surfaces. They are composed of layers of embedded, live bacteria within extruded exopolymeric matrix. This configuration allows for evasion of host defenses and decreased susceptibility to antibiotic therapy while maintaining the ability to deliberately release planktonic bacteria, resulting in recurrent acute infections. Thus, bacterial biofilms were hypothesized to contribute to the progression and persistence of chronic rhinosinusitis. Methods This review summarizes several of the seminal papers supporting this hypothesis. Results Multiple reports using various imaging modalities have demonstrated the presence of biofilms in sinonasal mucosa of patients with chronic rhinosinusitis. More recently, several studies have correlated the presence of biofilms with poor clinical outcomes in the disease process. Early therapeutic interventions have generated mixed results. Conclusions Bacterial biofilms appear to contribute to the progression of chronic rhinosinusitis in a subset of patients, although substantial effort toward therapeutic intervention is still necessary.

Bacterial Biofilms in Surgical Specimens of Patients with Chronic Rhinosinusitis

2005 ◽  
Vol 115 (4) ◽  
pp. 578-582 ◽  
Author(s):  
Jose A. Sanclement ◽  
Paul Webster ◽  
John Thomas ◽  
Hassan H. Ramadan
Keyword(s):  
Chronic Rhinosinusitis ◽  
Bacterial Biofilms

scholarly journals Association of initial imaging modality and futile recanalization after thrombectomy

Neurology ◽  
2020 ◽  
Vol 95 (17) ◽  
pp. e2331-e2342 ◽  
Author(s):  
Thomas Raphael Meinel ◽  
Johannes Kaesmacher ◽  
Pascal John Mosimann ◽  
David Seiffge ◽  
Simon Jung ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Mechanical Thrombectomy ◽  
Multivariate Analyses ◽  
Imaging Modality ◽  
Prediction Algorithm ◽  
Stroke Patients ◽  
Increased Risk ◽  
Selection For ◽  
Initial Imaging

ObjectiveTo test the hypothesis that selection by initial imaging modality (MRI vs CT) is associated with rate of futile recanalizations (FRs) after mechanical thrombectomy (MT), we assessed this association in a multicenter, retrospective observational registry (BEYOND-SWIFT [Registry for Evaluating Outcome of Acute Ischemic Stroke Patients Treated With Mechanical Thrombectomy], NCT03496064).MethodsIn 2,011 patients (49.7% female, median age 73 years [61–81]) included between 2009 and 2017, we performed univariate and multivariate analyses regarding the occurrence of FR. FRs were defined as 90-day modified Rankin Scale (mRS) score 4–6 despite successful recanalization in patients selected by MRI (n = 690) and CT (n = 1,321) with a sensitivity analysis considering only patients with mRS 5–6 as futile.ResultsMRI as compared to CT resulted in similar rates of subsequent MT (adjusted odds ratio [aOR] 1.048, 95% confidence interval [CI] 0.677–1.624). Rates of FR were as follows: 571/1,489 (38%) FR mRS 4–6 including 393/1,489 (26%) FR mRS 5–6. CT-based selection was associated with increased rates of FRs compared to MRI (44% [41%–47%] vs 29% [25%–32%], p < 0.001; aOR 1.77 [95% CI 1.25–2.51]). These findings were robust in sensitivity analysis. MRI-selected patients had a delay of approximately 30 minutes in workflow metrics in real-world university comprehensive stroke centers. However, functional outcome and mortality were more favorable in patients selected by MRI compared to patients selected with CT.ConclusionsCT selection for MT was associated with an increased risk of FRs as compared to MRI selection. Efforts are needed to shorten workflow delays in MRI patients. Further research is needed to clarify the role of the initial imaging modality on FR occurrence and to develop a reliable FR prediction algorithm.

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