Efficacy of neutral electrolyzed water in postoperative chronic rhinosinusitis patients—a pilot study

Lux, Christian A; Johnston, James; Biswas, Kristi; Douglas, Richard

doi:10.1002/alr.22683

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Neutral electrolysed water (NEW), which has hypochlorous acid (HOCL) as the main active ingredient, and povidone-iodine (PVI) are two examples of topical antiseptics with potential for treating biofilms. The bactericidal effects, as well as the efficacy and safety of NEW in CRS patients, have been demonstrated previously (23)(24)(25)(26) . While the excellent antimicrobial properties of PVI are well documented (27,28) , there have been concerns regarding its safety profile due to potential cytotoxic effects (29) .…”

Section: Introductionmentioning

confidence: 67%

The in vitro efficacy of neutral electrolysed water and povidone-iodine against CRS-associated biofilms

Lux¹,

Biswas²,

Taylor³

et al. 2021

Rhin

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Background: Despite best medical and surgical practice, some cases of chronic rhinosinusitis (CRS) can remain recalcitrant. Bacterial biofilms have been associated with the recalcitrance of sinonasal inflammation. Biofilms are highly resistant to commonly prescribed antibiotics. Accordingly, more effective antimicrobial treatment options are needed to treat refractory CRS. The aim of this study was to determine the in vitro efficacy of neutral electrolysed water (NEW) and povidone-iodine (PVI) against CRS-associated Staphylococcus aureus biofilms. Methods: Mature S. aureus biofilms were grown in a Centre for Disease Control (CDC) biofilm reactor. The antimicrobial activity of NEW, PVI and doxycycline was determined for both planktonic and biofilm cultures of a clinical S. aureus isolate using minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and minimum biofilm eradication concentration (MBEC) assays. Results: MICs and MBCs were determined for all antimicrobials. MBC values were similar to MICs for both antiseptics, but doxycycline MBCs were significantly higher than the associated MICs. Biofilms were highly resistant to NEW and doxycycline. The MBEC for doxycycline was between 500 and 1000 µg/mL. NEW was ineffective against biofilms and no MBEC could be determined. In contrast, a concentration of 10% of the commercial PVI solution (10 mg/mL PVI) led to effective eradication of mature biofilms. Conclusion: In this study, only PVI showed promising antibiofilm activity at physiological concentrations. The in vivo efficacy of PVI warrants further investigation of its potential as a treatment for recalcitrant CRS.

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Section: Introductionmentioning

confidence: 67%

The in vitro efficacy of neutral electrolysed water and povidone-iodine against CRS-associated biofilms

Lux¹,

Biswas²,

Taylor³

et al. 2021

Rhin

View full text Add to dashboard Cite

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“…Patient clinical and bacterial 16S rRNA gene amplicon sequencing data were obtained from previous studies conducted by our research group (Biswas et al, 2017(Biswas et al, , 2019Hoggard et al, 2017a;Jain et al, 2018;Wagner Mackenzie et al, 2019a;Lux et al, 2020). Amplicon sequence data originating from intra-operatively collected swab or tissue samples from 156 CRS patients diagnosed according to the EPOS 2012 criteria (Fokkens et al, 2012) and 45 disease control patients collected between 2015 and 2018 were collated (Supplementary Table 1).…”

Section: Cohorts and Data Acquisitionmentioning

confidence: 99%

Antibiotic Treatment for Chronic Rhinosinusitis: Prescription Patterns and Associations With Patient Outcome and the Sinus Microbiota

et al. 2020

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BackgroundChronic rhinosinusitis (CRS) is a common and debilitating inflammatory condition of the sinuses, afflicting 5% of the general population. Although antibiotics are frequently prescribed for the medical management of CRS, there is surprisingly little evidence to support their efficacy. In this study, we aimed to establish associations between medication usage, the sinus microbiota and patients’ clinical outcomes.MethodsAntibiotic prescription patterns for the year before sample collection of 156 CRS patients, 45 disease control patients (mostly requiring septoplasty and inferior turbinate reduction) and 35 healthy control subjects were examined and analyzed together with previously published bacterial 16S rRNA gene amplicon data from our group.ResultsThe highest antibiotic usage was observed among the two CRS patient categories. Despite heavy antibiotic usage, CRS patients’ clinical outcomes as indicated by patient questionnaires and radiologic scores were similar to those patients that did not receive any antibiotics. The sinus microbiota was dominated by members of the bacterial genera Corynebacterium and Staphylococcus in all three cohorts. Bacterial community dispersion as measured by principal coordinate analysis was significantly higher in CRS patients compared to healthy control subjects, but not disease control patients. Pairwise comparisons within cohorts revealed differences in the relative 16S rRNA gene sequence abundances of the genera Staphylococcus and Lawsonella between antibiotic users and non-users. However, overall antibiotic effects were minimal and unpredictable.ConclusionThe unpredictable effects of antibiotic treatment on the sinus microbiota found in this study, together with the lack of differences in patients’ symptom scores between cohorts, do not support preoperative antibiotic treatment for CRS patients.

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Characterising clinical Staphylococcus aureus isolates from the sinuses of patients with chronic rhinosinusitis

Mackenzie

Zoing

Clow

et al. 2021

Sci Rep

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The role of Staphylococcus aureus in the pathogenesis of the chronic sinonasal disease chronic rhinosinusitis (CRS), has not been definitively established. Comparative analyses of S. aureus isolates from CRS with those from control participants may offer insight into a possible pathogenic link between this organism and CRS. The intra- and inter-subject S. aureus strain-level diversity in the sinuses of patients with and without CRS were compared in this cross-sectional study. In total, 100 patients (CRS = 64, control = 36) were screened for S. aureus carriage. The overall carriage prevalence of S. aureus in this cohort was 24% (CRS n = 13, control n = 11). Cultured S. aureus isolates from 18 participants were strain-typed using spa gene sequencing. The bacterial community composition of the middle meatus was assessed using amplicon sequencing targeting the V3V4 hypervariable region of the bacterial 16S rRNA gene. S. aureus isolates cultured from patients were grown in co-culture with the commensal bacterium Dolosigranulum pigrum and characterised. All participants harboured a single S. aureus strain and no trend in disease-specific strain-level diversity was observed. Bacterial community analyses revealed a significant negative correlation in the relative abundances of S. aureus and D. pigrum sequences, suggesting an antagonistic interaction between these organisms. Co-cultivation experiments with these bacteria, however, did not confirm this interaction in vitro. We saw no significant associations of CRS disease with S. aureus strain types. The functional role that S. aureus occupies in CRS likely depends on other factors such as variations in gene expression and interactions with other members of the sinus bacterial community.

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Efficacy of neutral electrolyzed water in postoperative chronic rhinosinusitis patients—a pilot study

Cited by 3 publications

References 9 publications

The in vitro efficacy of neutral electrolysed water and povidone-iodine against CRS-associated biofilms

The in vitro efficacy of neutral electrolysed water and povidone-iodine against CRS-associated biofilms

Antibiotic Treatment for Chronic Rhinosinusitis: Prescription Patterns and Associations With Patient Outcome and the Sinus Microbiota

Characterising clinical Staphylococcus aureus isolates from the sinuses of patients with chronic rhinosinusitis

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