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Mendes BM, Bortoli ÉS, Zaleski CB, Martinelli MPD, Pascoal VF, Oliveira SD. Detection of multidrug-resistant bacteria in the nasal cavities and evaluation of sinus disorders in patients undergoing Le Fort I osteotomy. BMC Oral Health 2024; 24:533. [PMID: 38704542 PMCID: PMC11069297 DOI: 10.1186/s12903-024-04295-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/25/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION Orthognathic surgery can lead to sinus alterations, including sinusitis, attributed to the exposure of maxillary sinuses during Le Fort I osteotomy. Furthermore, being a hospital-based procedure, there is potential risk of complications arising from bacteria prevalent in such environments. This study evaluated maxillary sinusitis occurrence and the presence of multidrug-resistant bacteria in the nasal cavity before and after orthognathic surgery. METHODS Ten patients with dentofacial deformities underwent Le Fort I osteotomy. Clinical evaluations using SNOT-22 questionnaire were performed, and nasal cavity samples were collected pre-surgery and 3-6 months post-surgery to quantify total mesophilic bacteria and detect Staphylococcus aureus, Acinetobacter baumannii, and Klebsiella pneumoniae. Cone Beam Computed Tomography (CBCT) was performed pre- and post-operatively, and the results were evaluated using the Lund-Mackay system. This study was registered and approved by the Research Ethics Committee of PUCRS (No. 4.683.066). RESULTS The evaluation of SNOT-22 revealed that five patients showed an improvement in symptoms, while two remained in the same range of interpretation. One patient developed post-operative maxillary sinusitis, which was not detected at the time of evaluation by SNOT-22 or CBCT. CBCT showed a worsening sinus condition in three patients, two of whom had a significant increase in total bacteria count in their nasal cavities. The Brodsky scale was used to assess hypertrophy in palatine tonsils, where 60% of the subjects had grade 1 tonsils, 20% had grade 2 and 20% had grade 3. None of the patients had grade 4 tonsils, which would indicate more than 75% obstruction. Two patients harboured S. aureus and K. pneumoniae in their nasal cavities. Notably, K. pneumoniae, which was multidrug-resistant, was present in the nasal cavity of patients even before surgery, but this did not result in maxillary sinusitis, likely due to the patients' young and healthy condition. CONCLUSION There was an improvement in signs and symptoms of maxillary sinusitis and quality of life in most patients after orthognathic surgery. However, some patients may still harbour multidrug-resistant bacteria, even if they are asymptomatic. Therefore, a thorough pre-operative assessment is essential to avoid difficult-to-treat post-operative complications.
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Affiliation(s)
- Bárbara M Mendes
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Av. Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil
| | - Évelin S Bortoli
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Av. Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil
| | - Catherine B Zaleski
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Av. Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil
| | - Maila P D Martinelli
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Av. Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil
| | - Vanessa F Pascoal
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Av. Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil
| | - Sílvia D Oliveira
- Laboratório de Imunologia e Microbiologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Av. Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil.
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, RS, Brazil.
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Teh J, Biswas K, Waldvogel-Thurlow S, Broderick D, Clark ST, Johnston J, Wagner Mackenzie B, Douglas R. Paired qualitative and quantitative analysis of bacterial microcolonies in the tonsils of patients with tonsillar hyperplasia. Microbes Infect 2024; 26:105317. [PMID: 38452852 DOI: 10.1016/j.micinf.2024.105317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/03/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
The discovery of bacterial microcolonies in tonsillar tissue of patients with tonsillar hyperplasia has raised the question of their role in provoking the local immune response. Tonsils collected from patients undergoing tonsillectomy were stained for three clinically relevant bacterial taxa and lymphocytes. The bacterial composition and abundance of microcolonies was investigated using a combination of laser-microdissection, amplicon sequencing and Droplet Digital polymerase chain reaction. Microcolonies were detected in most samples (32/35) with a high prevalence of Haemophilus influenzae (78% of samples). B and T cell lymphocytes were significantly higher in the epithelium adjacent to microcolonies compared to epithelium distal to microcolonies. Furthermore, significant positive and negative correlations were identified between bacterial taxa and lymphocytes. Genus Streptococcus, which includes Group A Streptococcus (traditionally described as the main pathogen of tonsillar hyperplasia), was found in low abundance in this study. These results suggest other potential pathogens may be involved in stimulating the local immune response leading to tonsillar hyperplasia.
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Affiliation(s)
- Jackson Teh
- Department of Surgery, School of Medicine, The University of Auckland, Auckland, 1023, New Zealand
| | - Kristi Biswas
- Department of Surgery, School of Medicine, The University of Auckland, Auckland, 1023, New Zealand.
| | - Sharon Waldvogel-Thurlow
- Department of Surgery, School of Medicine, The University of Auckland, Auckland, 1023, New Zealand
| | - David Broderick
- Department of Surgery, School of Medicine, The University of Auckland, Auckland, 1023, New Zealand
| | - Sita Tarini Clark
- Te Whatu Ora - Te Toka Tumai Auckland, Health New Zealand, Auckland, 1142, New Zealand
| | - James Johnston
- Department of Surgery, School of Medicine, The University of Auckland, Auckland, 1023, New Zealand; Te Whatu Ora - Te Toka Tumai Auckland, Health New Zealand, Auckland, 1142, New Zealand
| | - Brett Wagner Mackenzie
- Department of Surgery, School of Medicine, The University of Auckland, Auckland, 1023, New Zealand
| | - Richard Douglas
- Department of Surgery, School of Medicine, The University of Auckland, Auckland, 1023, New Zealand; Te Whatu Ora - Te Toka Tumai Auckland, Health New Zealand, Auckland, 1142, New Zealand
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Salinero L, Blum JD, Wagner CS, Barrero CE, Pontell ME, Swanson JW, Bartlett SP, Taylor JA. Word of Mouth: Local Antisepsis Practices in Orthognathic Surgery and Opportunities for Innovation. Cleft Palate Craniofac J 2024; 61:513-516. [PMID: 36278755 DOI: 10.1177/10556656221134329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Affiliation(s)
- Lauren Salinero
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
| | - Jessica D Blum
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
| | - Connor S Wagner
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
| | - Carlos E Barrero
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
| | - Matthew E Pontell
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
| | - Jordan W Swanson
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
| | - Scott P Bartlett
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
| | - Jesse A Taylor
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, PA, USA
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Morawska-Kochman M, Malecha ZM, Zub K, Kielar J, Dudek K, Nelke K, Zatonski T. Physical Conditions Prevailing in the Nasal and Maxillary Sinus Cavities Based on Numerical Simulation. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1094. [PMID: 37374298 DOI: 10.3390/medicina59061094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: This paper presents a unique study that links the physical conditions in the nasal passage with conditions that favour the development of bacterial strains and the colonization of the mucous membranes of the nose and paranasal sinuses. The physical parameters considered were air flow, pressure, humidity, and temperature. Materials and Methods: Numerical models of the human nose and maxillary sinus were retrospectively reconstructed from CT images of generally healthy young subjects. The state-of-the-art numerical methods and tools were then used to determine the temperature, humidity, airflow velocity, and pressure at specific anatomical locations. Results: The results were compared with optimal conditions for bacterial growth in the nose and sinuses. Conclusions: Temperature, humidity, air velocity, and pressure were shown to play critical roles in the selection and distribution of microorganisms. Furthermore, certain combinations of physical parameters can favour mucosal colonisation by various strains of bacteria.
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Affiliation(s)
- Monika Morawska-Kochman
- Department of Otolaryngology, Head and Neck Surgery, Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Ziemowit Miłosz Malecha
- Department of Cryogenics and Aerospace Engineering, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
| | - Krzysztof Zub
- Department of Otolaryngology, Head and Neck Surgery, Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Jakub Kielar
- Department of Cryogenics and Aerospace Engineering, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
| | - Krzysztof Dudek
- Statistical Analysis Centre, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Kamil Nelke
- Maxillofacial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wroclaw, Poland
- Health Department, Academy of Applied Sciences, Academy of Silesius, Zamkowa 4, 58-300 Walbrzych, Poland
| | - Tomasz Zatonski
- Department of Otolaryngology, Head and Neck Surgery, Medical University, Borowska 213, 50-556 Wroclaw, Poland
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Hermansen GMM, Sazinas P, Kofod D, Millard A, Andersen PS, Jelsbak L. Transcriptomic profiling of interacting nasal staphylococci species reveals global changes in gene and non-coding RNA expression. FEMS Microbiol Lett 2019; 365:4794939. [PMID: 29325106 DOI: 10.1093/femsle/fny004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/08/2018] [Indexed: 12/14/2022] Open
Abstract
Interspecies interactions between bacterial pathogens and the commensal microbiota can influence disease outcome. In the nasal cavities, Staphylococcus epidermidis has been shown to be a determining factor for Staphylococcus aureus colonization and biofilm formation. However, the interaction between S. epidermidis and S. aureus has mainly been described by phenotypic analysis, and little is known about how this interaction modulates gene expression. This study aimed to determine the interactome of nasal S. aureus and S. epidermidis isolates to understand the molecular effect of interaction. After whole-genome sequencing of two nasal staphylococcal isolates, an agar-based RNA sequencing setup was utilized to identify interaction-induced transcriptional alterations in surface-associated populations. Our results revealed differential expression of several virulence genes in both species. We also identified putative non-coding RNAs (ncRNAs) and, interestingly, detected a putative ncRNA transcribed antisense to esp, the serine protease of S. epidermidis, that has previously been shown to inhibit nasal colonization of S. aureus. In our study, the gene encoding Esp and the antisense ncRNA are both downregulated during interaction with S. aureus. Our findings contribute to a better understanding of pathogen physiology in the context of interactions with the commensal microbiota, and may provide targets for future therapeutics.
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Affiliation(s)
- Grith M M Hermansen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, DK-2800 Kgs Lyngby, Denmark
| | - Pavelas Sazinas
- Department of Biotechnology and Biomedicine, Technical University of Denmark, DK-2800 Kgs Lyngby, Denmark
| | - Ditte Kofod
- Department of Biotechnology and Biomedicine, Technical University of Denmark, DK-2800 Kgs Lyngby, Denmark
| | - Andrew Millard
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 7RH, UK
| | - Paal Skytt Andersen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Lars Jelsbak
- Department of Biotechnology and Biomedicine, Technical University of Denmark, DK-2800 Kgs Lyngby, Denmark
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