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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
Department of Otology and Laryngology Harvard Medical School Division of Otolaryngology Brigham and Women’s Hospital, Boston, MA, USA
Despite the prevalence of chronic rhinosinusitis (CRS), its pathogenesis remains relatively poorly understood. Chronic infection has been long thought to play a role in the pathogenesis of CRS, but despite sophisticated surgical and culture techniques, the literature remains somewhat inconclusive on the true role of bacterial infection in CRS. In CRS, Staphlyococcal species predominate. However, recent data also suggest that anaerobic bacteria and Gram-negative bacteria may be adopting a more important role as causative agents in bacterial CRS. Such gram-negative bacteria are showing emerging patterns of antibiotic resistance. Similarly, fungi can be demonstrated in the majority of patients suffering from CRS, but they may also be identified in asymptomatic control patients. These data further complicate interpretations of the role of fungi in the pathogenesis of CRS. It is likely that bacterial or fungal infection is only part of a multifactorial pathogenesis of CRS; as such, CRS is much more than simply an infectious disorder of the sinuses. Awareness of the common bacteriology of CRS is important in guiding empiric antibiotic treatment and understanding medical and surgical treatment failures. However, more research is required into the microbiology of CRS and the pathogenic role of infectious organisms in CRS.