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Original Article


Evidence of Bacterial Biofilms in Nasal Polyposis


ME Zernotti,1* N Angel Villegas,2* M Roques Revol,1 CE Baena-Cagnani,3 JE Arce Miranda,2 ME Paredes,4 I Albesa,2 MG Paraje2

1Servicio de Otorrinolaringología, Sanatorio Allende, Córdoba, Argentina
2Departamento de Farmacia, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre y Medina Allende, Ciudad Universitaria, Córdoba, Argentina
3Facultad de Medicina, Universidad Católica de Córdoba, Argentina. Faculty of Specialization, Respiratory Medicine University of Genoa, Italy
4Departamento de Bacteriología, Sanatorio Allende, Córdoba, Argentina
*These authors contributed equally to this work

J Investig Allergol Clin Immunol 2010; Vol. 20(5): 380-385



Introduction: The pathogeny of chronic rhinosinusitis with nasal polyposis (CRS/NP) has not been elucidated. Bacterial exotoxins have been implicated in many inflammatory 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 typified 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 biofi lms in patients with CRS/NP. This chronic inflammatory factor might contribute to nasal mucosa damage, increased inflammatory cells in tissue, and the subsequent hyperplasic process.

Key words: Biofilms. Nasal polyposis. Chronic rhinosinusitis. Optical microscopy. Confocal scanning laser microscopy.