Microbiota Dysbiosis in Fungal Rhinosinusitis

Abstract

Fungal rhinosinusitis is a unique phenotype of chronic rhinosinusitis with unique clinical and histological characteristics. The role of bacterial microbiota in various phenotypes chronic rhinosinusitis is not thoroughly understood. Therefore, we conducted 16s rRNA amplification sequencing to determine differences in bacterial communities between phenotypes (fungal vs. non- fungal) and anatomical sites (middle meatus vs. nasopharynx). Endoscope-guided swabs were used to collect samples from the middle meatus and nasopharynx of seven consecutive patients with fungal and 18 consecutive patients with non-fungal rhinosinusitis. DNA was extracted and investigated through 16S rRNA amplification. Among samples from the middle meatus, Shannon diversity was significantly lower in those from the fungal rhinosinusitis group (p = 0.029). However, no significant differences in diversity were noted between nasopharynx samples (p = 0.85). Fungal rhinosinusitis samples exhibited a distinct distribution of taxon relative abundance, which involved not only the absence of rhinosinusitis-associated commensal Corynebacterium and Fusobacterium in the middle meatus but also a significant increase in Haemophilus prevalence and abundance. This is the first study to compare bacterial communities in fungal and non-fungal rhinosinusitis samples. Our findings demonstrated that bacterial community dysbiosis was more apparent in fungal rhinosinusitis samples and was limited to the middle meatus.

Mycotic Infection (Fungal Ball) of the Paranasal Sinuses: A Clinicopathological Observation

“…In accordance with our observations, fungal balls frequently occur in only one sinus and the maxillary sinus is most commonly affected [1][2][3][4][5][6][8][9][10]. The reasons for this phenomenon are unknown [5]. Typically, they occur in immunocompetent patients and are reported to be more prevalent among middle-aged and elderly females [1,3,4,6,9,10].…”

“…Therefore, a fungal ball was considered to be the most appropriate term [1][2][3][4]. In accordance with our observations, fungal balls frequently occur in only one sinus and the maxillary sinus is most commonly affected [1][2][3][4][5][6][8][9][10]. The reasons for this phenomenon are unknown [5].…”

“…This may be linked to the poor viability of the fungal hyphae. In culture-positive cases, the most commonly isolated pathogen is Aspergillus species [1,4,5,8,11]. However, as the fungal colonisation leads to bacterial microbiota dysbiosis, the coexistence of many types of bacteria can be identified in mycotic rhinosinusitis [5].…”

“…Mycotic infections of the nasal cavity and paranasal sinuses (fungal rhi-nosinusitis (FRS) are a spectrum of disorders rather than one distinct entity. They vary in clinical presentation, histopathologic appearances, and biological significance [1][2][3][4][5]. FRS is traditionally classified as non-invasive or invasive based on whether fungi have invaded into tissue or not [1,3,4,6].…”

Chronic Rhinosinusitis—An Update on Epidemiology, Pathogenesis and Management

“…Fungal rhinosinusitis is a unique type of CRS with special clinical and pathologic features. In their paper, Lu et al [ 17 ] explore the contribution of bacterial microbiota in different types of CRS. It is well known that conventional culture techniques provide limited evidence regarding bacterial pathogens.…”