Background: Staphylococcus aureus is the main pathogen infect chronic rhinosinusitis (CRS) and the biofilms play an essential role in the pathophysiology of infection and treatment of patients. However, research on clinical conditions is still limited. This study aimed to evaluate the relationship between S. aureus biofilms with severity and infection degree in CRS patients.
Methods: A post-test-only study was conducted at Dr Zaionel Abidin Hospital in Banda Aceh, Indonesia from January to April 2022. Thirty-five CRS patients, classified according to the disease severity and infection degree, were included and followed in the study. A mucosal swab on each patient was collected and biofilm formation analyzed quantitatively and qualitatively using a spectrophotometer and scanning electron microscope (SEM), respectively. The relationships between the bacterial growth, biofilm formation and mass of biofilms with the disease severity and degree of infection were assessed statistically.
Results: More than half of the patients (54.3%) were aged younger than 40 years, and 51.4% were male. Nasal congestion and rhinorrhoea were the most common reported obligate symptoms (78.2%) and 82.9% patients have additional symptom on facial pain. There was the relationship between bacterial growth and disease severity (p=0.046) and infection degree of CSR cases (p=0.031). Our data showed a significant association between biofilm formation and the disease severity (p=0.022) and infection degree of CSR patients (p=0.020). The mass of the biofilm was also associated significantly with disease severity (p=0.029) and degree of infection (p=0.018).
Conclusions: Our study shows that the formation and mass of biofilm associated with the disease severity and degree of infection in CSR. Biofilms may contribute to the clinical condition and also be considered during management of CRS patients.