ABSTRACT
Introduction: The etiopathogenie of chronic rhinosinusitis with nasal polyposis (CRS/NP) is still not clear. The bacterial exotoxins have been involved in many inflammatory chronic diseases like atopic dermatitis, asthma and more recently chronic CRS/NP. Objectives: We propose that the bacteria in CRS/NP are not only present in a planktonic state, but also occur in microbial communities developing biofilms. The aim of this work is to determine and characterize the presence of biofilms in CRS/NP. Study Design: A prospective study of the presence of biofilms in twelve patients undergoing endoscopic sinus surgery for nasal polyposis. Controls of four patients undegoing septoplasty were included. Methods: The samples were obtained from the surgery performed to the above mentioned patients. The bacteria were isolated and typified and the material was sent for in vitro by a spectrophotometer and in vivo biofilms research by means of optical microscopy and confocal scanning laser microscopy. Results: Nasal polyposis was studied in twelve patients. The isolated microorganisms were Staphylococcus aureus, Streptococcus viridans, coagulase-negative staphylococci, Pseudomonas aeruginosa, Enterococcus faecalis and Streptococcus viridans/Corinebacterium. It was observed moderated to high ability to form in vitro biofilms with values among 0,284±0,017 and 3,337±0,029. It was demonstrated in vivo biofilms in two patients. Conclusion: These bacteria in biofilms can have direct relation with CRS/NP since they would growth, produce virulence factors and contribute to an inflammatory chronic response. Further researches are required to clarify the impact of these biofilms in the etiopathology and symptoms of patients who develop CRS/NP.
