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Article

Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy

1
Department of Otolaryngology, Faculty of Medicine, Jagiellonian University Medical College, Sniadeckich 2, 31-531 Krakow, Poland
2
Jerzy Haber Institute of Catalysis and Surface Chemistry Polish Academy of Sciences, Niezapominajek 8, 30-239 Krakow, Poland
3
Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Garncarska 11, 31-115 Krakow, Poland
4
Biophage Pharma S.A., Mogilska 40, 31-546 Krakow, Poland
5
Department of Molecular Medical Microbiology Unit, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18, 31-121 Krakow, Poland
*
Author to whom correspondence should be addressed.
Received: 12 September 2019 / Revised: 1 October 2019 / Accepted: 1 October 2019 / Published: 5 October 2019
(This article belongs to the Special Issue Biofilm Infections — Time Bomb in Antibiotic Therapy)
The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis (ABRS), as our understanding of its microbiology is insufficient to establish specific treatment recommendations. Unfortunately, antibiotics frequently fail to control the symptoms of AECRS due to biofilm formation, disruption of the natural microbiota, and arising antibiotic resistance. These issues can potentially be addressed by phage therapy. In this study, the endoscopically-guided cultures were postoperatively obtained from 50 patients in order to explore the microbiology of AECRS, evaluate options for antibiotic treatment, and, most importantly, assess a possibility of efficient phage therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Haemophilus influenzae, Pseudomonas aeruginosa, and Enterobacteriaceae. Alarmingly, mechanisms of antibiotic resistance were detected in the isolates from 46% of the patients. Bacteria not sensitive to amoxicillin were carried by 28% of the patients. The lowest rates of resistance were noted for fluoroquinolones and aminoglycosides. Fortunately, 60% of the patients carried bacterial strains that were sensitive to bacteriophages from the Biophage Pharma collection and 81% of the antibiotic-resistant strains turned out to be sensitive to bacteriophages. The results showed that microbiology of AECRS is distinct from ABRS and amoxicillin should not be the antibiotic of first choice. Currently available bacteriophages could be used instead of antibiotics or as an adjunct to antibiotics in the majority of patients with AECRS. View Full-Text
Keywords: rhinosinusitis; exacerbations; bacteriophage; phage; antibiotic resistance; biofilm rhinosinusitis; exacerbations; bacteriophage; phage; antibiotic resistance; biofilm
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MDPI and ACS Style

Szaleniec, J.; Gibała, A.; Pobiega, M.; Parasion, S.; Składzień, J.; Stręk, P.; Gosiewski, T.; Szaleniec, M. Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy. Antibiotics 2019, 8, 175. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8040175

AMA Style

Szaleniec J, Gibała A, Pobiega M, Parasion S, Składzień J, Stręk P, Gosiewski T, Szaleniec M. Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy. Antibiotics. 2019; 8(4):175. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8040175

Chicago/Turabian Style

Szaleniec, Joanna, Agnieszka Gibała, Monika Pobiega, Sylwia Parasion, Jacek Składzień, Paweł Stręk, Tomasz Gosiewski, and Maciej Szaleniec. 2019. "Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy" Antibiotics 8, no. 4: 175. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8040175

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