背景:由于病原体的不同,鼻窦炎的亚型具有不同的症状和预后。牙源性上颌窦炎(OMS)主要发生在单侧,在临床特征上不同于通常发生在双侧的慢性鼻-鼻窦炎(CRS)。然而,OMS和CRS之间的全面微生物比较从未被系统地进行过,并且大多数比较在方法上存在偏差。本研究旨在通过荟萃分析方法对与OMS和CRS相关的微生物学进行全面分析,以便从微生物学角度为OMS和CRS的鉴别诊断提供证据。
方法:从PubMed和CNKI数据库开始至2023年7月进行搜索。采用随机效应模型来得出已识别的细菌物种或属的合并患病率估计值。
结果:代表的17项研究包括6项关于OMS,12关于CRS,和4个关于正常鼻窦,产生191、610和92个样本,分别。虽然没有统计学意义,与CRS相比,OMS中肽链球菌和普雷沃氏菌的患病率普遍较高.值得注意的是,与CRS相比,梭杆菌被鉴定为OMS中患病率明显更高的唯一属。
结论:与CRS相比,OMS中的梭杆菌明显更普遍,而金黄色葡萄球菌在CRS中比在OMS中更普遍。细菌谱的这种差异可能部分解释了观察到的独特病理,并有助于开发OMS中诊断和治疗干预的新策略。
BACKGROUND: Subtypes of sinusitis have different symptoms and prognoses due to different pathogens. Odontogenic maxillary sinusitis (OMS) mainly occurs unilaterally and is different from chronic rhinosinusitis (CRS) usually occurring bilaterally in terms of clinical characteristics. However, comprehensive microbiological comparisons between OMS and CRS have never been systematically conducted and most comparisons are methodologically biased. This study aims to provide a comprehensive analysis of the microbiology associated with OMS and CRS through a meta-analysis approach in order to provide evidence for differential diagnosis of OMS and CRS from a microbiological perspective.
METHODS: The databases PubMed and CNKI were searched from their inception to July 2023. A random-effects model was employed to derive the pooled prevalence estimates of the identified bacterial species or genera.
RESULTS: The 17 represented studies included 6 concerning OMS, 12 concerning CRS, and 4 concerning normal sinus, yielding 191, 610, and 92 samples, respectively. Though not statistically significant, the prevalence of Peptostreptococcus and Prevotella was generally higher in OMS compared to CRS. Notably, Fusobacterium was identified as the only genus with a significantly higher prevalence in OMS compared to CRS.
CONCLUSIONS: Fusobacterium was significantly more prevalent in OMS compared with CRS, while Staphylococcus aureus was more prevalent in CRS than in OMS. Such differences in bacterial profile may partly explain the distinct pathology observed and contribute to the development of novel strategies for diagnosis and therapeutic interventions in OMS.