(a) Phylogenetic tree of S. aureus isolates from CRSwNP, CRSsNP and control patients, mapping to specific clonal complexes and showing strain level variation in plasmid carrier status and virulence associated with disease phenotype; (b) Electron Microscopy image of a S. aureus bacteriophage
Chronic rhinosinusitis (CRS) or “sinusitis” is one of the most common diseases treated with antibiotics. This chronic and often long-term use of antibiotics significantly helps the bacteria to become resistant to antibiotics, fuelling the global “superbug epidemic”. New and better treatments that do not rely on antibiotics are urgently needed. Recently, new treatments against infections have been proposed that interfere with bacterial virulence factors or “toxins”. In contrast to antibiotics, such anti-virulence therapies do not affect the growth of the bacteria and do not invoke resistance. However, much is still unknown about the main bacterial virulence factors and their role in driving the chronic inflammation in CRS. Using advanced novel techniques that can determine the genomic sequence of various bacteria that we had isolated from CRS patients, we have found that certain virulence factors are only found in severe CRS patients that do not respond to therapy. In this project, we will develop new treatments that target only those virulence factors leaving the good bacteria and their secreted products unharmed. It is hoped that such therapies will reduce inflammation in those severe CRS cases without developing resistance to the therapy and without harming good bacteria that are required to maintain a healthy mucosa.