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Core swabs from nasal polyps- bacterial involvement? - an eastern indian scenario

Authors:Abheek Sil, Saurav Sarkar, Soma Sarkar, Manideepa SenGupta, Biswajit Sikder
Int J Biol Med Res. 2014; 5(4): 4491-4494  |  PDF File

Abstract

Background: Nasal polyps are benign lesions of the nasal sinuses/cavity which develop in patients with disturbed local homoeostasis of nasal mucosa. Aim: To identify the resident (control setup) and pathological (patients diagnosed with nasal polyps) bacterial flora; and establish empirical antibiotic policy to treat nasal polyp. Methods: This prospective study involving 105 patients with nasal polyp as “cases” and 105 healthy subjects as “controls” was conducted at Medical College, Kolkata to assess the involvement of bacteria in polyp formation. Post polypectomy core swabs were processed for isolation of aerobic and anaerobic bacteria and antibiotic sensitivity performed thereafter. Results: Polyp tissue core swabs from nasal polyp cases revealed 94.3% culture-positive specimens (p<0.05) with 99 aerobic and 129 anaerobic isolates. The predominant aerobes were S.aureus (45.4%), Klebsiella (15.2%), Pseudomonas (15.2%), Coagulase-negative Staphylococcus (15.2%), and Moraxella (6.1%). Peptostreptococcus (16.35), Porphyromonas (16.3%), Eubacterium (13.9%), Fusobacterium (13.9%), B.fragilis (9.3%) and Peptococcus (9.3%) frequented the anaerobes. The normal nasal flora comprised CONS (56.4%) followed by S.aureus (35.0%) and Corynebacterium (8.6%).The anaerobes in the nasal mucosa included Peptostreptococcus (44%), Fusobacterium (20%), Peptococcus (16%) and Porphyromonas (12%) among others. Levofloxacin showed an impressive overall 94.9% activity with 37 out of 39 gram negative and 57 out of 60 gram positive isolates being sensitive to it. Conclusion: This study illustrated the presence of polymicrobial aerobic-anaerobic bacteria in patients with nasal polyps and considered bacterial infection as an etiological factor in the pathogenesis of nasal polyp.