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Scanning electron micrograph of a Staphylococcus aureus biofilm.
Chronic rhinosinusitis (CRS) is a common and complex disease that is caused by the way bacteria and the immune system interact in the nose and sinuses. If medical treatment fails, CRS patients are offered sinus surgery but even after surgery some have persisting inflammation and infection. One reason for this is that they have bacteria on their mucosal surfaces in hard-to-remove colonies called “biofilms.” Antibiotics do not penetrate biofilms well, so they are resistant to this form of treatment.
We plan to look at antiseptic (not antibiotic) compounds that are active against bacteria in biofilms to see which are most effective against biofilms in the laboratory, and which are safe to apply to the nasal mucosa. Then, we will make the most effective of these compounds into a nasal spray. Patients who have had surgery for CRS but who have ongoing infection afterwards, will use these sprays or a placebo for one month. Over this time, we will take swabs from inside the nose to measure infection and immune activity, and track the patients’ symptoms. This will show us how useful these compounds are for treating resistant CRS and improving the quality of life of those who have it.