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Staphylococcus aureus prevalence in allergic fungal rhinosinusitis vs other subsets of chronic rhinosinusitis with nasal polyps

Authors

  • David W. Clark MD,

    1. Division of Otolaryngology–Head and Neck Surgery, Scott and White Hospitals and Clinics, Temple, TX
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  • Ashley Wenaas MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery and Texas Sinus Institute, University of Texas at Houston Medical School, Houston, TX
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  • Amber Luong MD, PhD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery and Texas Sinus Institute, University of Texas at Houston Medical School, Houston, TX
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  • Martin J. Citardi MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery and Texas Sinus Institute, University of Texas at Houston Medical School, Houston, TX
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  • Samer Fakhri MD

    Corresponding author
    • Department of Otorhinolaryngology–Head and Neck Surgery and Texas Sinus Institute, University of Texas at Houston Medical School, Houston, TX
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  • Potential conflict of interest: S.F. is a consultant for Terumo Corporation, Japan.

Correspondence to: Samer Fakhri, MD, FACS, FRCS(C), Department of Otorhinolaryngology–Head and Neck Surgery, University of Texas at Houston Medical School, 6431 Fannin MSB 5.036, Houston, TX 77030; e-mail: samer.fakhri@uth.tmc.edu

Abstract

Background

The pathogenesis of allergic fungal rhinosinusitis (AFRS) is thought to represent an immunological reaction to fungal antigens. Recent studies have implicated superantigens and non-immunoglobulin E (IgE)-mediated mechanisms in the development of AFRS. The objective of this study is to assess the prevalence of Staphylococcus aureus in AFRS vs other subsets of chronic rhinosinusitis with polyps (CRSwNP, also termed non-AFRS).

Methods

A case series with retrospective review of 19 patients with AFRS and 21 patients with CRSwNP was performed at a tertiary referral center. The diagnosis of AFRS required the presence of defined criteria described by Bent and Kuhn. Bacterial cultures and fungal cultures were analyzed for each group.

Results

S. aureus was significantly more prevalent in the AFRS group compared with the non-AFRS group (63.2% vs 24.1%, p = 0.005).

Conclusion

S. aureus has been implicated as a disease modifier in CRSwNP through superantigen-mediated mechanisms. This study demonstrates a higher prevalence of S. aureus in patients with AFRS vs patients with other subsets of CRSwNP (non-AFRS). These results support a potential role for S. aureus in the pathogenesis of AFRS.

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