Role of anaerobes in chronic sinusitis: Will polymerase chain reaction solve the debate

BACKGROUND: Bacteriology of chronic sinusitis continues to be a matter of debate, particularly the role of anaerobes. Some authors suggest that anaerobes play a significant role whereas others suggest a minimal role. Those who suggest a significant role argue that standard culture techniques are the culprits. OBJECTIVE: The purpose of this study was to use polymerase chain reaction (PCR) on sinus specimens for the presence of anaerobes and to compare them with standard culture techniques. METHODS: Sixty-four samples were obtained in a sterile fashion during sinus surgery and were sent for standard anaerobic cultures as well as anaerobic PCR analysis. RESULTS: Anaerobic bacteria were demonstrated in 5% of culture specimens, which is similar to recently published data. PCR identified anaerobic bacteria in 19% of the specimens (P = 0.01). CONCLUSION: PCR analysis of surgical samples obtained during endoscopic sinus surgery for chronic sinusitis identified a significantly higher incidence of anaerobes (x4) compared with standard. anaerobic culture technique.