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FUNGAL SPECIATION USING QUANTITATIVE POLYMERASE CHAIN REACTION (QPCR) IN PATIENTS WITH AND WITHOUT CHRONIC RHINOSINUSITIS
MURR, A. W., A. N. GOLDBERG, AND S. J. VESPER. FUNGAL SPECIATION USING QUANTITATIVE POLYMERASE CHAIN REACTION (QPCR) IN PATIENTS WITH AND WITHOUT CHRONIC RHINOSINUSITIS. The Laryngoscope. Lippincott Williams & Wilkins, Philadelphia, PA, 116(8):1342-1348, (2006).
1. Develop and publish a standard method or guidance document for QPCR analysis of microorganisms in environmental samples (air and water filtrates and dust).a standard method or guidance document for QPCR analysis of microorganisms in environmental samples (air and water filtrates and dust). Publication will involve a consensus standards organization. 2. Use QPCR methods to monitor childhood exposures to mold as a part of field studies, in order to establish whether a relationship exists between molds encountered in indoor environments and asthma-related health problems.
Objectives/Hypothesis: 1. to determine the mycology of the middle meatus using an endoscopically guided brush sampling technique and polymerase chain reaction laboratory processing of nasal mucous. 2. To compare the mycology of the middle meatus in patients with sinus disease to subjects without sinus disease. 3. To compare the responses on two standardized quality of life survey forms between patients with and without sinusitis, and to determine whether the presence of fungi in the middle meatus impacts responses on these data sets.
Study Design: A prospective case-controlled study.
Methods: Patients with sinus disease and patients without sinus disease were enrolled in the study. A disease specific, validated Sinonasal Outcomes Test survey was completed by the subjects (SNOT-20) and a generalized validated Medical Outcomes Short Form 36 Survey (SF-36) was also completed. An endoscopically guided brush sampling of nasal mucous was obtained from the middle meatus. Fungal specific quantitative polymerase chain reaction (QPCR) was performed on the obtained sample to identify one of 82 different species of fungus in the laboratory. Statistical analysis was used to categorize the recovered fungal DNA and to cross reference this information with the outcomes surveys.
Results: The fungal recovery rate in the study was 45.9% in patients with sinus disease and 45.9% in control subjects. Patients with chronic rhinosinusitis (CRS) had a mean SNOT-20 score of 1.80 versus the control group mean score of 0.77 (P<.0001). SF-36 data similarly showed a statistically significant difference between diseased and control populations with controls scoring a mean of 80.37 and chronic rhinosinusitis patients scoring a mean of 69.35 for a P-value of .02. However, no statistical significance could be ascribed to the presence or absence of fungi recovered, the type of fungi recovered, or the possible impact of fungi on the quality of life survey results.
Conclusion: The recovery rate of fungi from the middle meatus of patients with and without chronic rhinosinusitis is 45.9% using QPCR techniques. No direct causation with regard to fungal species or presence was proven, however, a species grouping for future studies is proposed based upon trends in these data and other reports. Disease specific outcomes surveys revealed a statistically significant difference between the two patient groups.
Record Details:Record Type: DOCUMENT (JOURNAL/PEER REVIEWED JOURNAL)
Organization:U.S. ENVIRONMENTAL PROTECTION AGENCY
OFFICE OF RESEARCH AND DEVELOPMENT
NATIONAL EXPOSURE RESEARCH LABORATORY
MICROBIOLOGICAL AND CHEMICAL EXPOSURE ASSESSMENT DIVISION
MICROBIAL EXPOSURE RESEARCH BRANCH