Comment; This 2014 article identifies that CoNS presence alone does not predict problems after sinus surgery. Although mention of biofilms is made in the article, the authors don’t seem to recognize it’s importance.
Zi Zhang, MD, MSCE,1Nithin D. Adappa, MD,2Ebbing Lautenbach, MD, MPH, MSCE,1,3Alexander G. Chiu, MD,4Laurel J. Doghramji, RN, BSN,2Noam A. Cohen, MD, PhD,2,5 and James N. Palmer, MD2Author informationCopyright and License informationDisclaimerThe publisher’s final edited version of this article is available at Int Forum Allergy RhinolSee other articles in PMC that cite the published article.Go to:
Abstract
Objective
Coagulase-negative staphylococcus (CoNS) is commonly isolated from patients with chronic rhinosinusitis (CRS). However, the role of CoNS in CRS remains controversial. We aimed to determine the associations between positive CoNS culture at functional endoscopic sinus surgery (FESS) and CRS severity.
Methods
Adult CRS patients who underwent FESS between 10/1/2007 to 12/31/2011 were recruited. Patient demographics, disease characteristics, medication use, Lund-Mackay CT scores, and SNOT-22 scores were collected at baseline before FESS. Intraoperative cultures were obtained in a standard manner. Patients were placed into two groups based on culture findings: patients with CoNS as the sole positive culture result and patients with all other positive culture results, including CoNS, as part of a polymicrobial culture.
Results
376 CRS patients met the criteria. 106 patients (28%) had CoNS as their only isolate, 260 (69%) had other positive cultures, and 10 (3%) had no bacterial growth. Compared to patients with other positive cultures, patients with the sole result of CoNS were significantly less likely to have a history of FESS (52% versus 65%, p=0.019), nasal polyps (50% versus 65%, p=0.006), and had a better Lund-Mackay CT score (11.95 versus 14.18, p=0.020). After adjusting for all factors in the multiple logistic regression model, CoNS as the sole positive culture result was independently associated with having no history of FESS (OR=0.45, 95%CI, 0.22-0.94, p=0.034).
Conclusion
Positive intraoperative CoNS cultures alone do not result in increased CRS disease burden by objective or subjective measures as compared to patients with other bacterial or polymicrobial culture isolates
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