<scp>MRSA</scp> chronic bacterial laryngitis: A growing problem

Carpenter, Patrick; Kendall, Katherine A.

doi:10.1002/lary.26955

Cited by 7 publications

(20 citation statements)

References 18 publications

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“…Among the MRSA cohort, 100% responded to redirected therapy with trimethoprim-sulfamethoxazole. 4 In-office culturing of the larynx with a flexible laryngoscope tip offers a noninvasive approach to identifying this antibiotic resistance.…”

Section: Resultsmentioning

confidence: 99%

Use of a transnasal flexible laryngoscope tip for laryngeal culturing: A novel in‐office technique

Michael

Vesole

Diekema

et al. 2021

Laryngoscope Investig Oto

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Background: In-office culture of the larynx using a flexible laryngoscope tip can help identify laryngeal pathogens in cases of laryngitis.Objective: This retrospective case series aimed to investigate the feasibility of inoffice laryngoscope tip culture to identify laryngeal pathogens and help guide medical treatment.Methods: This case series consists of 8 patients who underwent 11 in-office laryngeal cultures using the tip of the flexible laryngoscope. Concurrent nasal cultures were performed on two patients to assess for possible nasal contamination of these laryngoscope tip cultures.Results: Nine patients underwent laryngeal culture with laryngoscope tip in-office, with two patients undergoing repeat swabs for a total of eleven swabs. Then, 8 of 11 swabs (73%) grew methicillin-sensitive Staphylococcus aureus, while 1 of 11 (9.1%) swabs grew methicillin-resistant S. aureus. Three of eleven swabs (27%) grew Candida species. Concurrent culture was performed of the contralateral nasal cavity in two patients to assess for the possibility of nasal contamination of laryngoscope tip cultures. Concurrent contralateral nasal cultures grew distinct pathogens compared to the laryngeal cultures, suggesting that nasal contamination did not occur. Conclusion:In-office laryngoscope tip culture allows safe identification of laryngeal pathogens in an ambulatory setting. In-office laryngoscope tip culture can help guide medical treatment of laryngeal infections.

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Section: Resultsmentioning

confidence: 99%

Use of a transnasal flexible laryngoscope tip for laryngeal culturing: A novel in‐office technique

Michael

Vesole

Diekema

et al. 2021

Laryngoscope Investig Oto

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“…From these, 64 were related to VF granuloma, 129 to laryngotracheal stenosis, 100 to laryngeal infections, and 48 to leukoplakia. Among these articles, 31 met our inclusion criteria and were kept for analysis ( Figure 1 ): 8 related to VF granuloma ( Table 1 ), 20-27 4 to laryngeal infections ( Table 1 ), 28-31 5 to leukoplakia ( Table 2 ), 7,32-35 and 10 to laryngotracheal stenosis ( Table 3 ). 36-45 Four additional basic research studies were identified concerning the relationship between reflux and the development of laryngotracheal stenosis.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies focused on the relationship between LPR and chronic laryngeal infections—namely, laryngeal papillomatosis 28,30,31 and methicillin-resistant Staphylococcus aureus (MRSA). 29 The papillomatosis articles are described in Table 1 . In the study of Carpenter and Kendall, there was no significant association between the development and the recurrence of MRSA-related laryngeal infection and the presence of suspected GERD.…”

Section: Resultsmentioning

confidence: 99%

“…In 13 studies, the LPR diagnosis was not confirmed through objective examination, or the diagnosis method was not provided. 7,24-27,29,32,33,37-39,42,45 Among these studies, some authors considered GERD symptoms for the diagnosis without considering LPR-associated complaints. 7,32,39,42,45 The objective approaches used for the reflux diagnosis included x-ray 20 ; gastrointestinal endoscopy findings 20,34 ; single-probe, 20,43 dual-probe, 21-23,28 triple-probe, 36,40 or oropharyngeal 41 pH monitoring; manometry 20 ; and pepsin detection.…”

Section: Resultsmentioning

confidence: 99%

“…A large number of studies based the LPR diagnosis on LPR- or GERD-associated symptoms and findings. 7,24-27,29,32,37-39,42,45 Considering only GERD symptoms creates a selection bias, as LPR is primarily characterized by ear, nose, and throat symptoms, as opposed to GERD where digestive symptoms are predominant. 1 The lack of consideration of laryngopharyngeal symptoms may indirectly exclude some patients with LPR who do not also have digestive complaints.…”

Section: Discussionmentioning

confidence: 99%

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Involvement of Laryngopharyngeal Reflux in Select Nonfunctional Laryngeal Diseases: A Systematic Review

Lechien¹,

Akst

Saussez

et al. 2020

Otolaryngol.--head neck surg.

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Objectives To investigate the existing published evidence supporting the role of laryngopharyngeal reflux (LPR) in the development of the select nonfunctional laryngeal diseases of laryngotracheal stenosis, granuloma, leukoplakia, and laryngeal infections Data Sources PubMed, Cochrane Library, and Scopus. Review Methods A systematic review was performed by 3 independent investigators for studies providing information about the prevalence and role of LPR in the development of laryngotracheal stenosis, granuloma, leukoplakia, and laryngeal infections. Diagnostic criteria and clinical outcome evaluation of included studies were analyzed with PRISMA criteria. Results Of the 64 relevant publications, 27 clinical and 4 basic science studies were included. Ten studies used objective reliable examinations for LPR diagnosis (eg, dual- or triple-probe or oropharyngeal pH monitoring, multichannel intraluminal impedance–pH monitoring, or pepsin detection). According to the bias analysis and the results of studies, the association between LPR and laryngotracheal stenosis, leukoplakia, laryngeal papillomatosis, or vocal fold granuloma remains poorly demonstrated. There is a notable heterogeneity among included studies regarding their inclusion criteria, diagnostic methods, and clinical outcome evaluation. Although some experimental findings support the involvement of bile salts and other gastroduodenal proteins active in alkaline pH, no included clinical studies assessed the role of nonacid and mixed reflux through multichannel intraluminal impedance–pH monitoring. Conclusion The involvement of LPR in the development of leukoplakia, laryngotracheal stenosis, vocal fold granuloma, and laryngeal papillomatosis is currently not demonstrated. The potential relationship between LPR and these select nonfunctional laryngeal diseases must be confirmed through future clinical and experimental studies considering acid, nonacid, and mixed LPR.

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Practical Application of Culture‐Directed Treatment for Chronic Bacterial Laryngitis

et al. 2023

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Background/ObjectivesSituated at the center of the upper aerodigestive tract, the larynx often is susceptible to a variety of insults including infection. Manifestations of laryngitis include hoarseness, cough, and sore throat, among others. The purpose of this research is to better understand the clinical presentation and patient characteristics of chronic infectious laryngitis. We aim to better understand when culture‐directed therapy should be initiated in patients presenting to the otolaryngologist with suspected chronic infectious laryngitis and how this may influence treatment outcomes.MethodsA single center, retrospective chart review was performed for patients with laryngitis of >3 weeks duration and who had positive laryngeal cultures obtained at a tertiary referral laryngology office from January 2016 through January 2023.ResultsTwenty‐four patients (ages 36–84 years) with 29 positive cultures of the larynx met inclusion criteria. Ninety percent of patients were already on acid suppression therapy prior to culture acquisition. Fifty‐five percent were immunocompromised. The most common species of bacterial growth included Klebsiella sp. (27.5%), Staphylococcus sp. (27.5%), and methicillin‐resistant staphylococcus sp. (13.7%). Twelve cultures (41.4%) revealed multiple bacterial species, and 10 cultures (34.5%) had concomitant fungal isolates. The average treatment duration was 10 days. Twenty‐one patients (72%) experienced improvement or resolution in symptoms after completion of culture‐directed therapy.ConclusionsThe use of culture‐directed therapy for chronic bacterial laryngitis was helpful in the determination of appropriate treatment in these cases. More studies are needed to determine the optimal timing of cultures, duration of treatment, and implications of concomitant fungal laryngitis.Level of Evidence4 Laryngoscope, 2023

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MRSA chronic bacterial laryngitis: A growing problem

Abstract: 4. Laryngoscope, 128:921-925, 2018.

Cited by 7 publications

References 18 publications

Use of a transnasal flexible laryngoscope tip for laryngeal culturing: A novel in‐office technique

Use of a transnasal flexible laryngoscope tip for laryngeal culturing: A novel in‐office technique

Involvement of Laryngopharyngeal Reflux in Select Nonfunctional Laryngeal Diseases: A Systematic Review

Practical Application of Culture‐Directed Treatment for Chronic Bacterial Laryngitis

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