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Introduction
Chronic rhinosinusitis is characterised by chronic inflammation of the sinonasal mucosa that persists for at least 12 weeks despite medical therapy.1It is one of the most prevalent chronic diseases, affecting approximately 11 per cent of the European population.2Chronic rhinosinusitis is often divided into two clinically and phenotypically distinct subtypes: chronic rhinosinusitis with and without nasal polyps.1Unlike acute bacterial sinusitis, whose pathophysiology is well defined, it is increasingly acknowledged that chronic rhinosinusitis is not a single disease entity. Instead, it is a heterogeneous condition broadly characterised by persistent inflammation of the sinonasal mucosa.3The causes of such inflammation are diverse and multifactorial, relating to overlapping host and environmental triggers.3
Mycoplasma pneumoniae and Chlamydophila pneumoniae are bacteria known to cause respiratory tract infections.4Both have been associated with community-acquired pneumonia and acute bronchitis, and with persistent asthma and chronic obstructive pulmonary disease (COPD) infections.4-10Taking into account the unified airway theory,10which considers allergic rhinitis, rhinosinusitis and COPD as manifestations of the same inflammatory process within a continuous airway, it is also possible that these bacteria may cause persistent infection of the sinus mucosa in patients with chronic rhinosinusitis with nasal polyps.
A few studies have investigated the potential role of M pneumoniae11-14and C pneumoniae9,13,15-17in chronic rhinosinusitis with nasal polyps using different techniques, although their results are controversial. In our study, we used real-time polymerase chain reaction to evaluate and compare the prevalence of M pneumoniae and C pneumoniae DNA in the nasal tissue samples of patients with chronic rhinosinusitis with nasal polyps and in those from healthy controls. To our knowledge, real-time polymerase chain reaction has not previously been used to assess the prevalence of M pneumoniae and C pneumoniae DNA in nasal tissue samples.
Methods
We conducted a prospective study from May 2010 to May 2014, involving adult patients with chronic rhinosinusitis with nasal polyps undergoing functional endoscopic sinus surgery (FESS). We made a diagnosis of chronic rhinosinusitis with nasal polyps according to the criteria set out in the European Position Paper on Rhinosinusitis and Nasal Polyps.1The control group...