Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis

Objective: To demonstrate DNA sequencing analysis (DNAsa) of sinus cultures in patients with CRS is a reliable method of detecting pathogens in polymicrobial CRS infections. Methods: After obtaining Institutional Review Board approval for this prospective cohort study, we selected a random sample of...

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Autores principales:	Sarah K. Rapoport, Alyssa J. Smith, Maxwell Bergman, Kelly A. Scriven, Itzhak Brook, Suzette K. Mikula
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2019
Materias:	Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/4b136083132445198c27f9e609655612
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spelling	oai:doaj.org-article:4b136083132445198c27f9e6096556122021-12-02T12:02:39ZDetermining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis2095-881110.1016/j.wjorl.2018.11.001https://doaj.org/article/4b136083132445198c27f9e6096556122019-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881118301033https://doaj.org/toc/2095-8811Objective: To demonstrate DNA sequencing analysis (DNAsa) of sinus cultures in patients with CRS is a reliable method of detecting pathogens in polymicrobial CRS infections. Methods: After obtaining Institutional Review Board approval for this prospective cohort study, we selected a random sample of 50 patients with CRS at Medstar Georgetown University Hospital between September 2016 and March 2017. We defined CRS as a history of rhinosinusitis refractory to maximal medical therapy and prior endoscopic sinus surgery. Patients demonstrating active purulence in a sinus cavity were prospectively selected to undergo standard hospital cultures (SHC) and DNAsa cultures. Organisms identified in both methods were compared for each patient. Results: Specimens were obtained from 29 female and 16 male patients with a mean age of 50 years. A total of 45 cultures were included in our final analysis; five cultures were excluded after inappropriate laboratory processing. Results from these patients were compared and analyzed. Cohen's weighted kappa analysis showed agreement between the two testing methods in identifying predominant microorganisms. DNAsa detected 31.9% more microorganisms compared to SHC (P < 0.05). When multiple microorganisms were detected, DNAsa yielded more positive results compared to SHC (P < 0.05). Conclusions: DNAsa detects all microorganisms identified by SHC as well as predominant microorganisms not detected by SHC. Thus molecular pathogen identification may be more reliable for identifying multiple microorganisms as compared to standard culture techniques that identify only one or two microorganisms. In recalcitrant cases of CRS, DNAsa may provide better guidance in selection of appropriate antimicrobial treatment. Keywords: Chronic rhinosinusitis (CRS), DNA sequencing analysis (DNAsa), Microbiome, Molecular sequencing, Microbiology cultureSarah K. RapoportAlyssa J. SmithMaxwell BergmanKelly A. ScrivenItzhak BrookSuzette K. MikulaKeAi Communications Co., Ltd.articleOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 5, Iss 2, Pp 82-87 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Otorhinolaryngology RF1-547 Surgery RD1-811 Sarah K. Rapoport Alyssa J. Smith Maxwell Bergman Kelly A. Scriven Itzhak Brook Suzette K. Mikula Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis
description	Objective: To demonstrate DNA sequencing analysis (DNAsa) of sinus cultures in patients with CRS is a reliable method of detecting pathogens in polymicrobial CRS infections. Methods: After obtaining Institutional Review Board approval for this prospective cohort study, we selected a random sample of 50 patients with CRS at Medstar Georgetown University Hospital between September 2016 and March 2017. We defined CRS as a history of rhinosinusitis refractory to maximal medical therapy and prior endoscopic sinus surgery. Patients demonstrating active purulence in a sinus cavity were prospectively selected to undergo standard hospital cultures (SHC) and DNAsa cultures. Organisms identified in both methods were compared for each patient. Results: Specimens were obtained from 29 female and 16 male patients with a mean age of 50 years. A total of 45 cultures were included in our final analysis; five cultures were excluded after inappropriate laboratory processing. Results from these patients were compared and analyzed. Cohen's weighted kappa analysis showed agreement between the two testing methods in identifying predominant microorganisms. DNAsa detected 31.9% more microorganisms compared to SHC (P < 0.05). When multiple microorganisms were detected, DNAsa yielded more positive results compared to SHC (P < 0.05). Conclusions: DNAsa detects all microorganisms identified by SHC as well as predominant microorganisms not detected by SHC. Thus molecular pathogen identification may be more reliable for identifying multiple microorganisms as compared to standard culture techniques that identify only one or two microorganisms. In recalcitrant cases of CRS, DNAsa may provide better guidance in selection of appropriate antimicrobial treatment. Keywords: Chronic rhinosinusitis (CRS), DNA sequencing analysis (DNAsa), Microbiome, Molecular sequencing, Microbiology culture
format	article
author	Sarah K. Rapoport Alyssa J. Smith Maxwell Bergman Kelly A. Scriven Itzhak Brook Suzette K. Mikula
author_facet	Sarah K. Rapoport Alyssa J. Smith Maxwell Bergman Kelly A. Scriven Itzhak Brook Suzette K. Mikula
author_sort	Sarah K. Rapoport
title	Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis
title_short	Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis
title_full	Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis
title_fullStr	Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis
title_full_unstemmed	Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis
title_sort	determining the utility of standard hospital microbiology testing: comparing standard microbiology cultures with dna sequence analysis in patients with chronic sinusitis
publisher	KeAi Communications Co., Ltd.
publishDate	2019
url	https://doaj.org/article/4b136083132445198c27f9e609655612
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Determining the utility of standard hospital microbiology testing: Comparing standard microbiology cultures with DNA sequence analysis in patients with chronic sinusitis

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