B-243. Biofilms in Chronic Rhinosinusitis

J. G. Leid1, A. Gmerek1, L. Neveling1, J. Kofonow1, E. Cope1, A. Sanderson2, D. Healy2, D. Hunsaker2, E. Schwartz1, M. E. Shirtliff3, N. Cohen4, J. Palmer4;
1Northern Arizona Univ., Flagstaff, AZ, 2United States Naval Med. Ctr., San Diego, CA, 3Univ. of Maryland, Baltimore, MD, 4Univ. of Pennsylvania, Philadelphia, PA.

Chronic Rhinosinusitis (CRS) negatively impacts the performance and well being of millions of Americans annually. It is one of the most common medical complaints, affecting up to 16% of the general human population, with an estimated aggregated cost in the United States of 6 billion dollars annually. Yet, it’s etiology is complex and poorly understood. The full battery of microorganisms that cause CRS, as well as the accompanying, microbial-specific immune response leading to chronic infection, remain uncharacterized. Recently, we, and others, have demonstrated that microorganisms living as biofilms are an integral part of CRS pathology, most notably because of the inherent resistant (both antibiotic and host defense resistance) phenotype associated with biofilms. Collectively, there is a dramatic and incomplete understanding of the disease which is currently driving incomplete treatment regimes. Here, we report the presence of bacterial and fungal biofilms associated with explanted human nasal sinus tissue by microbial specific fluorescent DNA probes (FISH). Our data demonstrate the presence of microbial biofilms that are uncommonly cultured in the clinical laboratory. We have also investigated the bacterial communities associated with healthy and CRS tissue through complementary molecular approaches. These data suggest that different microbial communities are present in CRS than in healthy tissue. Collectively, our group has begun to unravel some of the enigmas that result in Chronic Rhinosinusitis in humans.