Author(s)
Abdurrahman Abdurrob, MD MS
Jacob G. Eide, MD
Amrita Ray, DO
Jacob S. Ancira, MPH
Craig D. Tipton, PhD
John R. Craig, MD
Affiliation(s)
1Henry Ford Hospital Department of Otolaryngology - Head and Neck Surgery, 2Mayo Clinic Department of Otolaryngology - Head and Neck Surgery, 3MicroGenDX, Lubbock, Texas
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to appreciate the unique microbial biodiversity of odontogenic sinusitis.
Objectives: Odontogenic sinusitis (ODS) is a unique form of bacterial sinusitis stemming from infectious dental pathologies, and its microbiology differs from non-odontogenic rhinosinusitis. However, bacterial diversity as determined by bacterial culture versus next generation DNA sequencing (NGS) has been incompletely studied. This study's purpose was to analyze sinus microbial diversity in ODS patients based on NGS and bacterial cultures.
Study Design: Prospective observational.
Methods: ODS and control patients who underwent endoscopic sinonasal surgery were enrolled. In ODS, maxillary sinus purulence was collected. In controls, the middle meatus was swabbed. NGS and aerobic/anaerobic bacterial cultures were obtained from each specimen.
Results: For the 20 ODS and 12 control patients, mean ages were 60.5 and 42.5 years, and 55% and 58% were female, respectively. On average, NGS identified 4.9 bacteria per ODS case, and 1.9 per control. Bacterial cultures identified 2.6 bacteria per ODS case. Twenty-one NGS species were significantly different between ODS and control groups, of which the most differentiating in ODS patients were streptococcus intermedius, fusobacterium nucleatum, and prophyromonas endodontalis, and those from controls were Cutibacterium acnes and staphylococcus epidermidis (p<0.05). Beta diversity testing showed a statistically significant difference between ODS and control microbial communities (p=0.001). Based on bacterial cultures, staphylococcus epidermidis (24%), streptococcus intermedius (14%), streptococcus constellatus (10%) were the most commonly cultured bacteria in ODS patients.
Conclusions: ODS patients have a unique biodiversity that may be better understood using NGS. Future studies should explore whether NGS improves diagnostic accuracy and clinical outcomes in ODS.