Nine Cases of Methanogenic Archaea in Refractory Sinusitis, an Emerging Clinical Entity

• Main Authors: Elisabeth Sogodogo (Author), Mustapha Fellag (Author), Ahmed Loukil (Author), Vanessa Demonfort Nkamga (Author), Justin Michel (Author), Patrick Dessi (Author), Pierre-Edouard Fournier (Author), Michel Drancourt (Author)
• Format: Book
• Published: Frontiers Media S.A., 2019-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The authors report the cases of 9 patients eventually diagnosed with methanogenic archaea refractory or recalcitrant chronic rhinosinusitis, a condition known to involve various anaerobic bacteria but in which the role of methanogenic archaea is unknown. The authors retrospectively searched these microorganisms by PCR in surgically-collected sinusal pus specimens from patients diagnosed with refractory sinusitis, defined by the persistance of sinus inflammation and related-symptoms for more than 12 weeks despite appropriate treatment. Of the 116 tested sinus surgical specimens, 12 (10.3%) from 9 patients (six females, three males; aged 20-71 years) were PCR-positive. These specimens were further investigated by fluorescence in-situ hybridization, PCR amplicon-sequencing and culture. Methanobrevibacter smithii was documented in four patients and Methanobrevibacter oralis in another four, one of whom was also culture-positive. They were associated with a mixed flora including Gram-positive and Gram-negative bacteria. In the latter patient, "Methanobrevibacter massiliense" was the sole microorganism detected. These results highlight methanogenic archaea as being part of a mixed anaerobic flora involved in refractory sinusitis, and suggest that the treatment of this condition should include an antibiotic active against methanogens, notably a nitroimidazole derivative.

Item Description

2296-2565
10.3389/fpubh.2019.00038