Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (5): 132-138.doi: 10.6040/j.issn.1673-3770.0.2018.603

• Meta-analysis • Previous Articles    

Meta analysis of the nasal cavity bacterial culture in chronic rhinosinusitis

Shujing HAN1,Jie LU1,Ping CHU1,Lixing TANG2,Huiwen ZHENG1,Xiaojian YANG2,Wei ZHANG2,Pengpeng WANG2,Jie ZHANG2,Yongli GUO1,Wentong GE1,2()   

  1. 1. Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health (NCCH), Beijing 100045,China
    2. Department of Otolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health (NCCH), Beijing 100045,China
  • Received:2018-12-11 Revised:2019-05-07 Online:2019-09-20 Published:2019-10-15
  • Contact: Wentong GE E-mail:gewentong@bch.com.cn

Abstract: Objective

To clarify the bacterial distribution in the nasal cavity of patients with chronic rhinosinusitis and provide a basis for the diagnosis and treatment of Chronic Rhinosinusitis (CRS).

Methods

PubMed, EMBASE, MEDLINE, CNKI, VIP Information and Wanfang data were searched for studies on the nasal cavity bacterial culture in CRS. Search strategy: chronic rhinosinusitis AND (microbio* OR bacteria OR virus); Chinese retrieval (rhinosinusitis) AND (microecology OR bacteria OR virus).

Results

Totally, 2141 cases of CRS were included in 20 studies. The pooled positive rates of Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa and Haemophilus influenzae were 0.24(95%CI: 0.17 ~ 0.31), 0.17(95%CI: 0.11 ~ 0.23), 0.06(95%CI: 0.02 ~ 0.11), 0.09(95%CI: 0.05 ~ 0.14), and 0.09(95%CI: 0.03 ~ 0.15), respectively.

Conclusion

S. aureus and S. epidermidis are the main pathogenic bacteria present in the nasal cavity of CRS patients, followed by S. pneumoniae, P. aeruginosa, and H. influenzae.

Key words: Chronic rhinosinusitis, Bacteria culture, Meta analysis

CLC Number: 

  • R765.4

Table 1

Summary of data incorporated into the literature on bacterial distribution"

作者 发表时间(年) 国家 样本量(例) 男(例) 年龄(岁) 取样部位 金黄色葡萄球菌 肺炎链球菌 表面葡萄球菌 卡他莫拉菌 铜绿假单胞杆菌 CNS 流感嗜血杆菌 大肠埃希菌 奇异变形杆菌 甲型链球菌 肺炎克雷伯菌
Araujo E等[4] 2007 Brazil 134 NA NA 中鼻道 53 22 19 13 10
Bro?ekm?dry等[11] 2012 Poland 64 NA 5-18 中鼻道 33 2 7 35 11
Busaba等[12] 2004 USA 179 74 NA 中鼻道 33 7 5 9 8 8
Chan 等[13] 2001 USA 83 NA NA 中鼻道 2 10 8 6 26 21
Cleland 等[14] 2013 Australia 513 280 51

鼻腔黏液、

黏膜

178 26 10 44 23 19
Feazel 等[15] 2012 USA 15 5 45 中鼻道 10 15 18
Jiang等[16] 2015 USA 105 46 46.3 中鼻道 31 6 6 25 6 15
Mantovani等[17] 2010 Brazil 62 30 45 上颌窦 4 3 4 8 1 2 15
Niederfuhr等[18] 2009 Germany 13 9 49 鼻腔灌洗液 1 2 12 4 1
Rombaux等[19] 2005 Belgium 176 NA NA 中鼻道 37 5 7 11
Stokken等[20] 2014 USA 41 29 11.8 中鼻道 8 4 1 9 2
Walgama等[21] 2013 USA 49 20 49.2 中鼻道 22 1 15 1 3
李军等[22] 2016 China 175 104 43 上颌窦及筛窦 26 1 41 6 6 1 1
魏洪政等[23] 2017 China 125 85 45.5 中鼻道 13 25 9 40 4 1
张太等[24] 2016 China 63 40 46.25 中鼻道 6 6 3 1
何文霞等[25] 2015 China 100 56 32.6 上颌窦 22 6 10
王士杰等[26] 2015 China 43 28 45.2 中鼻道 4 2 6 5 2 1
肖立志等[27] 2011 China 51 27 44 鼻腔黏液 1 1 17 2
张永兰等[28] 2015 China 63 39 47 中鼻道 6 4 3 1
林华等[29] 2015 China 87 49 44.6 鼻腔分泌物 23 12 15 10 5

Table 2

Summary of data incorporated into the literature on virus distribution"

作者 发表时间(年) 国家 样本量(例) 男(例) 年龄(岁) 取样部位 检测方法 鼻病毒 呼吸道合胞病毒 流感病毒A和B群 副流感病毒
Abshirini等[30] 2015 IR Iran 76 48 44.3 鼻腔黏液 qPCR 28 15
Cho等[31] 2013 Republic of Korea 111 67 72.8 鼻腔灌洗液 qPCR 29 12 15 26
Liao等[32] 2014 China 61 44 28 中鼻道黏膜 qPCR 5 22 18

Fig.1

Forest plot of the positive rate of Staphylococcus aureus "

Fig.2

Forest plot of the positive rate of Staphylococcus epidermidis"

Fig.3

Forest plot of the positive rate of Streptococcus pneumoniae "

Fig.4

Forest plot of the positive rate of Pseudomonas aeruginosa"

Fig.5

Forest plot of the positive rate of Haemophilus influenzae"

Fig.6

Funnel plot of potential publication bias of Staphylococcus aureus studies"

1 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组 . 慢性鼻-鼻窦炎诊断和治疗指南(2012年, 昆明)[J]. 中华耳鼻咽喉头颈外科杂志,2013, 48(2): 92-94. doi:10.3760/cma.j.issn.1673-0860.2013. 02.002 .
doi: 10.3760/cma.j.issn.1673-0860.2013. 02.002
2 Joss TV , Burke CM , Hudson BJ , et al . Bacterial Communities Vary between Sinuses in Chronic Rhinosinusitis Patients [J]. Front Microbiol, 2016,6:1532. doi: 10.3389/fmicb.2015.01532. eCollection 2015 .
doi: 10.3389/fmicb.2015.01532. eCollection 2015
3 Hoggard M , Wagner Mackenzie B , Jain R , et al . Chronic rhinosinusitis and the evolving understanding of microbial ecology in chronic inflammatory mucosal disease[J]. Clin Microbiol Rev, 2017, 30(1): 321-348. doi:10. 1128/cmr.00060-16 .
doi: 10. 1128/cmr.00060-16
4 Araujo E , Dall C , Cantarelli V , et al . Microbiology of middle meatus in chronic rhinosinusitis[J]. Brazilian Journal of Otorhinolaryngology, 2007, 73(4): 549-555. doi:10.1016/s1808-8694(15)30108-7 .
doi: 10.1016/s1808-8694(15)30108-7
5 Copeland E , Leonard K , Carney R , et al . Chronic rhinosinusitis: potential role of microbial dysbiosis and recommendations for sampling sites[J]. Front Cell Infect Microbiol, 2018, 8: 57. doi:10.3389/fcimb.2018.00057 .
doi: 10.3389/fcimb.2018.00057
6 Bhattacharyya N . The role of infection in chronic rhinosinusitis[J]. Curr Allergy Asthma Rep, 2002, 2(6): 500-506. doi:10.1007/s11882-002-0091-1 .
doi: 10.1007/s11882-002-0091-1
7 覃纲, 梁灼萍, QIN Gang , 等 . 变应性真菌性鼻-鼻窦炎免疫治疗现状[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 23-26. doi:10.6040/j.issn.1673-3770.1.2018.006 .
doi: 10.6040/j.issn.1673-3770.1.2018.006
QIN Gang , LIANG Zhuoping , QIN Gang , et al . Status of immunotherapy in allergic fungal rhinosinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(3): 23-26. doi:10.6040/j.issn.1673-3770.1.2018.006 .
doi: 10.6040/j.issn.1673-3770.1.2018.006
8 Casiano R . Treatment of acute and chronic rhinosinusitis[J]. Seminars in Respiratory Infections, 2000, 15(3): 216-226. doi:10.1053/srin.2000.18071 .
doi: 10.1053/srin.2000.18071
9 Kato A . Immunopathology of chronic rhinosinusitis[J]. Allergology International, 2015, 64(2): 121-130. doi:10.1016/j.alit.2014.12.006 .
doi: 10.1016/j.alit.2014.12.006
10 Yan Y , Gordon WM , Wang DY . Nasal epithelial repair and remodeling in physical injury, infection, and inflammatory diseases[J]. Current Opinion in Otolaryngology & Head and Neck Surgery, 2013, 21(3): 263-270. doi:10.1097/moo.0b013e32835f80a0 .
doi: 10.1097/moo.0b013e32835f80a0
11 Brożek-Mądry E , Chmielik LP , Gałązka A , et al . Chronic rhinosinusitis in children: Bacteriological analysis in terms of cytological examination[J]. International Journal of Pediatric Otorhinolaryngology, 2012, 76(4): 512-522. doi:10.1016/j.ijporl.2012.01.008 .
doi: 10.1016/j.ijporl.2012.01.008
12 Busaba NY , Siegel NS , Salman SD . Microbiology of chronic ethmoid sinusitis: Is this a bacterial disease?[J]. American Journal of Otolaryngology, 2004, 25(6): 379-384. doi:10.1016/j.amjoto.2004.04.001 .
doi: 10.1016/j.amjoto.2004.04.001
13 Chan J , Hadley J . The microbiology of chronic rhinosinusitis: results of a community surveillance study [J]. Ear Nose Throat J, 2001, 80(3):143-145.doi:10.1177/014556130108000309
doi: 10.1177/014556130108000309
14 Cleland EJ , Bassiouni A , Wormald PJ . The bacteriology of chronic rhinosinusitis and the pre-eminence ofStaphylococcus aureusin revision patients[J]. International Forum of Allergy and Rhinology, 2013, 3(8): 642-646. doi:10.1002/alr.21159 .
doi: 10.1002/alr.21159
15 Feazel LM , Robertson CE , Ramakrishnan VR , et al . Microbiome complexity and Staphylococcus aureus in chronic rhinosinusitis[J]. The Laryngoscope, 2012, 122(2): 467-472. doi:10.1002/lary.22398 .
doi: 10.1002/lary.22398
16 Jiang ZY , Kou YF , Batra PS . Endoscopic culture-directed antibiotic therapy: Impact on patient symptoms in chronic rhinosinusitis[J]. American Journal of Otolaryngology, 2015, 36(5): 642-646. doi:10.1016/j.amjoto.2015.04.009 .
doi: 10.1016/j.amjoto.2015.04.009
17 Mantovani K , Bisanha AA , Demarco RC , et al . Maxillary sinuses microbiology from patients with chronic rhinosinusitis [J]. Brazilian Journal of Otorhinolaryngology, 2010, 76(5):548-551.doi:10.1590/S1808-869420-10000500002
doi: 10.1590/S1808-869420-10000500002
18 Niederfuhr A , Kirsche H , Riechelmann H , et al . The bacteriology of chronic rhinosinusitis with and without nasal polyps[J]. Arch Otolaryngol Head Neck Surg, 2009, 135(2): 131. doi:10.1001/archoto.2008.531 .
doi: 10.1001/archoto.2008.531
19 Rombaux P , Collet S , Hamoir M , et al . The role of nasal cavity disinfection in the bacteriology of chronic sinusitis [J]. Rhinology, 2005, 43(2):125-129.
20 Stokken J , Gupta A , Krakovitz P , et al . Rhinosinusitis in children: A comparison of patients requiring surgery for acute complications versus chronic disease[J]. American Journal of Otolaryngology, 2014, 35(5): 641-646. doi:10.1016/j.amjoto.2014.05.008 .
doi: 10.1016/j.amjoto.2014.05.008
21 Walgama E , Thanasumpun T , Gander R , et al . Comparison of endoscopically-guided swab vs aspirate culture techniques in post-endoscopic sinus surgery patients: blinded, prospective analysis[J]. International Forum of Allergy and Rhinology, 2013, 3(9): 726-730. doi:10.1002/alr.21170 .
doi: 10.1002/alr.21170
22 李军, 吴彦桥, 李晓明, 等 . 慢性鼻-鼻窦炎伴或不伴鼻息肉患者细菌培养及药敏试验分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(2): 115-118. doi:10.13201/j.issn.1001-1781.2016.02.007 .
doi: 10.13201/j.issn.1001-1781.2016.02.007
LI Jun , WU Yanqiao , LI Xiaoming , et al . Distribution and drug sensitivity test of bacteria of patients on chronic rhinosinusitis with or without nasal polyps[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(2): 115-118. doi:10.13201/j.issn.1001-1781.2016.02.007 .
doi: 10.13201/j.issn.1001-1781.2016.02.007
23 魏洪政, 王向东, 朱敏, 等 . 不同外周血嗜酸粒细胞表型的慢性鼻-鼻窦炎伴鼻息肉的微生物学研究[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(5): 338-342. doi:10.13201/j.issn.1001-1781.2017.05.003 .
doi: 10.13201/j.issn.1001-1781.2017.05.003
WEI Hongzheng , WANG Xiangdong , ZHU Min , et al . The microbiology of chronic rhinosinusitis with nasal polyps in different phenotype of peripheral blood eosinophils[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31(5): 338-342. doi:10.13201/j.issn.1001-1781.2017.05.003 .
doi: 10.13201/j.issn.1001-1781.2017.05.003
24 张太, 龚齐 . 对慢性鼻-鼻窦炎患者细菌学检测及药敏的探究[J]. 中国实用医药, 2016, 11(22): 13-14. doi:10.14163/j.cnki.11-5547/r.2016.22.007 .
doi: 10.14163/j.cnki.11-5547/r.2016.22. 007
ZHANG Tai , GONG Qi . Investigation of microbiological detection and drug sensitivity in chronic rhinosinusitis patients[J]. China Practical Medicine, 2016, 11(22): 13-14. doi:10.14163/j.cnki.11-5547/r.2016.22. 007 .
doi: 10.14163/j.cnki.11-5547/r.2016.22. 007
25 何文霞, 汪文银 . 慢性鼻-鼻窦炎鼻分泌物细菌培养及药敏试验[J]. 中国耳鼻咽喉颅底外科杂志, 2015, 21(5): 413-415. doi:10.11798/j.issn.1007-1520. 2015-05017 .
doi: 10.11798/j.issn.1007-1520. 2015-05017
26 王士杰, 王好真, 马玉茹, 等 . 慢性鼻-鼻窦炎的细菌培养与药敏分析[J]. 中国耳鼻咽喉头颈外科, 2015, 22(6): 296-298. doi:10.16066/j.1672-7002.2015.06. 009 .
doi: 10.16066/j.1672-7002.2015.06.009
WANG Shijie , WANG Haozhen , MA Yuru , et al . Analysis of bacterial culture and antimicrobial susceptibility of chronic rhinosinusitis[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2015, 22(6): 296-298. doi:10.16066/j.1672-7002.2015.06.009 .
doi: 10.16066/j.1672-7002.2015.06.009
27 肖立智, 郑静, 杨蕾, 等 . 慢性鼻-鼻窦炎患者窦腔的细菌分布及药敏观察[J]. 临床耳鼻咽喉头颈外科杂志, 2011, 25(15): 692-694. doi:10.3969/j.issn.1001-1781.2011.15.008 .
doi: 10.3969/j.issn.1001-1781.2011.15.008
XIAO Lizhi , ZHENG Jing , YANG Lei , et al . Microbial profile and antibiotic susceptibility of chronic rhinosinusitis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2011, 25(15): 692-694. doi:10.3969/j.issn.1001-1781.2011.15.008 .
doi: 10.3969/j.issn.1001-1781.2011.15.008
28 张永兰, 孙沛涌, 林鹏, 等 . 慢性鼻-鼻窦炎患者细菌学检测及药敏分析[J]. 中国耳鼻咽喉头颈外科, 2015, 22(1): 35-37. doi:10.16066/j.1672-7002.2015.01.009 .
doi: 10.16066/j.1672-7002.2015.01.009
ZHANG Yonglan , SUN Peiyong , LIN Peng , et al . Distribution and drug sensitivity test of bacteria for patients with chronic rhinosinusitis[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2015, 22(1): 35-37. doi:10.16066/j.1672-7002.2015.01.009 .
doi: 10.16066/j.1672-7002.2015.01.009
29 林华, 潘成军, 陈赛赛, 等 . 我院2013-2015年慢性鼻-鼻窦炎鼻腔分泌物细菌学特征及药敏分析[J]. 中国药房, 2015, 26(35): 4949-4950. doi:10.6039/j.issn.1001-0408.2015.35.17 .
doi: 10.6039/j.issn.1001-0408.2015.35.17
LIN Hua , PAN Chengjun , CHEN Saisai , et al . Analysis of bacteriological characteristics and drug sensitivity of nasal secretions of chronic rhinosinusitis (CRS)in our hospital from 2013 to 2015[J]. China Pharmacy, 2015, 26(35): 4949-4950. doi:10.6039/j.issn.1001-0408.2015.35.17 .
doi: 10.6039/j.issn.1001-0408.2015.35.17
30 Abshirini H , Makvandi M , Seyyed Ashrafi M , et al . Prevalence of rhinovirus and respiratory syncytial virus among patients with chronic rhinosinusitis[J]. Jundishapur J Microbiol, 2015, 8(3): e20068. doi:10.5812/jjm.20068 .
doi: 10.5812/jjm.20068
31 Cho GS , Moon BJ , Lee BJ , et al . High rates of detection of respiratory viruses in the nasal washes and mucosae of patients with chronic rhinosinusitis[J]. J Clin Microbiol, 2013, 51(3): 979-984. doi:10.1128/jcm. 028-06- 12 .
doi: 10.1128/jcm. 028-06- 12
32 Liao B , Hu CY , Liu T , et al . Respiratory viral infection in the chronic persistent phase of chronic rhinosinusitis[J]. The Laryngoscope, 2014, 124(4): 832-837. doi:10. 1002/lary.24348 .
doi: 10. 1002/lary.24348
33 何寒青, 陈坤 . Meta分析中的异质性检验方法[J]. 中国卫生统计, 2006, 23(6): 486-487,490. doi:10.3969/j.issn.1002-3674.2006.06.002 .
doi: 10.3969/j.issn.1002-3674.2006.06.002
HE Hanqing , CHEN Kun . Methods for measuring heterogeneity in a meta-analysis[J]. Chinese Journal of Health Statistics, 2006, 23(6): 486-487,490. doi:10.3969/j.issn.1002-3674.2006.06.002 .
doi: 10.3969/j.issn.1002-3674.2006.06.002
[1] Huabin LI,Yuting LAI,Wenxiu JIANG. Endotypes and precision medicine in chronic sinusitis treatment [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 9-13.
[2] Hongmeng YU,Zhuofu LIU,Qi DAI. Endoscopic sinus surgery for chronic sinusitis with asthma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 38-41.
[3] Yu ZHANG,Xicheng SONG. Advances in interaction mechanisms and treatment strategy between chronic rhinosinusitis with nasal polyp and asthma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 49-52.
[4] WANG Yakun, ZHANG Yu, SONG Xicheng. Analysis of pulmonary function and its influencing factors in chronic rhinosinusitis without lower airway disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 99-102.
[5] WANG Jianwei, ZHANG Yu, SONG Xicheng. Analysis of pulmonary function of patients who developed chronic rhinosinusitis with nasal polyps and asthma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 103-108.
[6] SONG Xiaoyu, ZHANG Yu, LI Chenglin, SONG Xicheng. Enhanced recovery after surgery for the treatment of chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5): 9-12.
[7] GONG Qi, ZHANG Jie, ZHAO Pingping. Effect of nasal dilation on quality of sleep in adult patients with chronic rhinosinusitis and [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(2): 52-55.
[8] LIN Xing, LIN Zongtong, SHEN Ling.. Outcomes of sinus balloon catheter dilation in treatment of pediatric chronic rhinosinusitis: a systematic review and meta-analysis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(6): 79-86.
[9] LUN Jie, ZHANG Ya′nan. Analysis on the factors related to the recurrence of chronic rhinosinusitis with nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 80-83.
[10] . Progress of tight junctions and chronic rhinosinusitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(2): 112-115.
[11] XIE Zhaofeng, LIN Honghao. Analysis of clinical risk factors on the postoperative prognosis of chronic rhinosinusitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(4): 90-93.
[12] SU Yi, XIE Jinghua, PAN Xiaoli, ZENG Guoqing. Efficacy and associated factors of endoscopic sinus surgery on patients with chronic rhinosinusitis with or without nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(4): 86-89.
[13] ZHANG Jinling, CAI Xiaolan, LI Xuezhong, FENG Xin, QI Junjun, LIU Dayu. Study of autophagy-related genes atg3, ambra1 expressions in chronic rhinosinusitis without or with nasal polyps accompanied with asthma. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 50-55.
[14] ZI Xiaoxue, ZHAO Li, JIN Peng, TU Yanyi, LI Ang, SHI Li.. Improvement of the olfaction and quality of life of the chronic rhinosinusitis patients with olfactory disorders. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(1): 21-25.
[15] WANG Zhiyuan, ZHANG Gehua. Establishment and application of model of chronic rhinosinusitis in mice [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(5): 76-78.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!