Zusammenfassung
Wissenschaftler halten bakterielle Biofilme in 65 % aller Infektionskrankheiten für
die Ursache. In der Hals-Nasen-Ohrenheilkunde erfüllen häufige Erkrankungen wie chronische
Tonsillitis, chronische Sinusitis, Otitis media mit Paukenerguss und Otitis media
epitympanalis die Kriterien einer biofilmassoziierten Erkrankung: mit Antibiose unzureichend
therapierbare Entzündungen, die durch einen schubweisen Verlauf charakterisiert sind.
Zudem werden in unserem Fachgebiet häufig medizinische Implantate im Bereich von belüfteten
Arealen (Mittelohr, Trachea, Nasennebenhöhlen) verwendet, die nachweislich für die
Besiedelung mit Biofilmen anfällig sind. Auf den folgenden Seiten werden charakteristische
Merkmale von Biofilmen mit ihrer Entwicklung dargestellt, Erkenntnisse mit Bezug auf
HNO-ärztliche Erkrankungen zusammengefasst und derzeitige bzw. künftige Therapieansätze
erläutert.
Abstract
Today, 65 % of all infections are regarded as a consequence of local biofilms. In
Otorhinolaryngology frequent diseases including chronic tonsillitis, chronic sinusitis,
otitis media with effusion and cholesteatomas fulfill the clinical criteria of biofilm-associated
diseases such as recalcitrant disease, inefficiently treated with long-term antibiotics.
Apart from affecting a great proportion of our clinical spectrum, ENT-specialist frequently
insert implants into ventilated area such as trachea, middle ear and paranasal sinuses,
all susceptible for biofilm attachment. In short, relevant characteristics of biofilms
and their development are summarized, clinical knowledge of otorhinolaryngologic diseases
is presented and current and future therapeutic approaches are discussed.
Schlüsselwörter
Biofilm - Pathophysiologie - Mikrobiologie - Sinusitis - Otitis media
Key words
biofilm - pathophysiology - microbiology - sinusitis - otitis media
Literatur
- 1
Ferguson B J, Stolz D B.
Demonstration of biofilm in human bacterial chronic rhinosinusitis.
Am J Rhinol.
2005;
19
452-457
- 2
Post J C, Stoodley P, Hall-Stoodley L, Ehrlich G D.
The role of biofilms in otolaryngologic infections.
Current opinion in otolaryngology & head and neck surgery.
2004;
12
185-190
- 3
Costerton J W, Stewart P S, Greenberg E P.
Bacterial biofilms: a common cause of persistent infections.
Science.
1999;
284
1318-1322
- 4
Hall-Stoodley L, Costerton J W, Stoodley P.
Bacterial biofilms: from the natural environment to infectious diseases.
Nature reviews.
2004;
2
95-108
- 5
Donlan R M.
Biofilms: microbial life on surfaces.
Emerging infectious diseases.
2002;
8
881-890
- 6
Donlan R M, Costerton J W.
Biofilms: survival mechanisms of clinically relevant microorganisms.
Clinical microbiology reviews.
2002;
15
167-193
- 7
Davies D G, Parsek M R, Pearson J P. et al .
The involvement of cell-to-cell signals in the development of a bacterial biofilm.
Science.
1998;
280
295-298
- 8
Hall-Stoodley L, Stoodley P.
Biofilm formation and dispersal and the transmission of human pathogens.
Trends Microbiol.
2005;
13
7-10
- 9
Wilson S, Hamilton M A, Hamilton G C, Schumann M R, Stoodley P.
Statistical quantification of detachment rates and size distributions of cell clumps
from wild-type (PAO1) and cell signaling mutant (JP1) Pseudomonas aeruginosa biofilms.
Applied and environmental microbiology.
2004;
70
5847-5852
- 10
Rather P N.
Swarmer cell differentiation in Proteus mirabilis.
Environ Microbiol.
2005;
7
1065-1073
- 11
Bendouah Z, Barbeau J, Hamad W A, Desrosiers M.
Use of an in vitro assay for determination of biofilm-forming capacity of bacteria
in chronic rhinosinusitis.
Am J Rhinol.
2006;
20
434-438
- 12
Ha K R, Psaltis A J, Tan L, Wormald P J.
A sheep model for the study of biofilms in rhinosinusitis.
Am J Rhinol.
2007;
21
339-345
- 13
Psaltis A J, Ha K R, Beule A G, Tan L W, Wormald P J.
Confocal scanning laser microscopy evidence of biofilms in patients with chronic rhinosinusitis.
Laryngoscope.
2007;
117
1302-1306
- 14
Vlastarakos P V, Nikolopoulos T P, Maragoudakis P, Tzagaroulakis A, Ferekidis E.
Biofilms in ear, nose, and throat infections: how important are they?.
Laryngoscope.
2007;
117
668-673
- 15
Ehrlich G D, Veeh R, Wang X. et al .
Mucosal biofilm formation on middle-ear mucosa in the chinchilla model of otitis media.
JAMA.
2002;
287
1710-1715
- 16
Dingman J R, Rayner M G, Mishra S. et al .
Correlation between presence of viable bacteria and presence of endotoxin in middle-ear
effusions.
Journal of clinical microbiology.
1998;
36
3417-3419
- 17
Post J C, Preston R A, Aul J J. et al .
Molecular analysis of bacterial pathogens in otitis media with effusion.
JAMA.
1995;
273
1598-1604
- 18
Rayner M G, Zhang Y, Gorry M C. et al .
Evidence of bacterial metabolic activity in culture-negative otitis media with effusion.
JAMA.
1998;
279
296-299
- 19
Costerton J W.
Introduction to biofilm.
International journal of antimicrobial agents.
1999;
11
217-221; discussion 237 - 239
- 20
Hall-Stoodley L, Hu F Z, Gieseke A. et al .
Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic
otitis media.
JAMA.
2006;
296
202-211
- 21
Chole R A, Faddis B T.
Evidence for microbial biofilms in cholesteatomas.
Arch Otolaryngol Head Neck Surg.
2002;
128
1129-1133
- 22
Post J C.
Direct evidence of bacterial biofilms in otitis media.
Laryngoscope.
2001;
111
2083-2094
- 23
Perloff J R, Palmer J N.
Evidence of bacterial biofilms in a rabbit model of sinusitis.
Am J Rhinol.
2005;
19
1-6
- 24
Al-Shemari H, Abou-Hamad W, Libman M, Desrosiers M.
Bacteriology of the sinus cavities of asymptomatic individuals after endoscopic sinus
surgery.
J Otolaryngol.
2007;
36
43-48
- 25
Bendouah Z, Barbeau J, Hamad W A, Desrosiers M.
Biofilm formation by Staphylococcus aureus and Pseudomonas aeruginosa is associated
with an unfavorable evolution after surgery for chronic sinusitis and nasal polyposis.
Otolaryngol Head Neck Surg.
2006;
134
991-996
- 26
Zuliani G, Carron M, Gurrola J. et al .
Identification of adenoid biofilms in chronic rhinosinusitis.
Int J Pediatr Otorhinolaryngol.
2006;
70
1613-1617
- 27
Chole R A, Faddis B T.
Anatomical evidence of microbial biofilms in tonsillar tissues: a possible mechanism
to explain chronicity.
Arch Otolaryngol Head Neck Surg.
2003;
129
634-636
- 28
Desrosiers M, Bendouah Z, Barbeau J.
Effectiveness of topical antibiotics on Staphylococcus aureus biofilm in vitro.
Am J Rhinol.
2007;
21
149-153
- 29
Swords W E, Rubin B K.
Macrolide antibiotics, bacterial populations and inflammatory airway disease.
Neth J Med.
2003;
61
242-248
- 30
Ramadan H H, Sanclement J A, Thomas J G.
Chronic rhinosinusitis and biofilms.
Otolaryngol Head Neck Surg.
2005;
132
414-417
- 31
Sanclement J A, Webster P, Thomas J, Ramadan H H.
Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis.
Laryngoscope.
2005;
115
578-582
- 32
Sanderson A R, Leid J G, Hunsaker D.
Bacterial biofilms on the sinus mucosa of human subjects with chronic rhinosinusitis.
Laryngoscope.
2006;
116
1121-1126
- 33
Kania R E, Lamers G E, Vonk M J. et al .
Demonstration of bacterial cells and glycocalyx in biofilms on human tonsils.
Arch Otolaryngol Head Neck Surg.
2007;
133
115-121
Dr. Achim Georg Beule
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie
Walther-Rathenau-Straße 43 - 45
17487 Greifswald
Email: achim.beule@uni-greifswald.de