{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:48:51Z","timestamp":1791848931300,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Antibiotics are frequently prescribed for acute exacerbations of chronic rhinosinusitis (CRS). However, antimicrobial resistance presents a challenge for the ongoing and future management of CRS patients.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to examine the current and past microbiological yield and antimicrobial resistance profile in a tertiary sinus centre.<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n A retrospective results review for the calendar years from 2015 to 2018 and 2019 to 2024 was conducted on all CRS patients who had sinonasal microbiological samples taken during their outpatient visits with a history of previous endoscopic sinus surgery (ESS).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 706 cultures were analysed from 338 patients. Clinically significant organisms were identified in 60.0% of cases in 2015\u20132018 and 71.9% of cases in 2019\u20132024 (\n p<\/jats:italic>\n \u2009=\u20090.003). Whilst\n \n Staphylococcus aureus<\/jats:italic>\n <\/jats:styled-content>\n remained the predominant isolate in both groups, Gram\u2010negative organisms rose significantly (32.9%\u201346.5%,\n p<\/jats:italic>\n \u2009=\u20090.004), particularly non\u2010\n Pseudomonas<\/jats:italic>\n and Enterobacteriaceae species. Interestingly, classical acute bacterial rhinosinusitis pathogens (\n \n Staphylococcus pneumoniae<\/jats:italic>\n <\/jats:styled-content>\n ,\n \n Moraxella catarrhalis<\/jats:italic>\n <\/jats:styled-content>\n ,\n \n Haemophilus influenzae<\/jats:italic>\n <\/jats:styled-content>\n ) were detected in only 28.0% and 23.8% of cases in the respective study periods. Resistance to clarithromycin in\n \n S. aureus<\/jats:italic>\n <\/jats:styled-content>\n isolates increased significantly from 12.1% to 27.5% (\n p<\/jats:italic>\n \u2009=\u20090.0008), whilst resistance to doxycycline and amoxicillin also rose, though these changes were not statistically significant. Resistance to co\u2010amoxiclav increased from 0.3% to 3.2% in 2019\u20132024. (\n p<\/jats:italic>\n \u2009=\u20090.0276).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n There has been an increase in the incidence of Gram\u2010negative bacteria as well as antibiotic resistance in CRS sinonasal cultures. These findings emphasise the importance of endoscopically guided cultures and culture\u2010directed antibiotic therapy when managing postoperative CRS exacerbations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/coa.70172","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:00:44Z","timestamp":1791846044000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evolution of Bacterial Yield and Antimicrobial Resistance in Chronic Rhinosinusitis Patients in a Dedicated Sinus Centre"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0098-046X","authenticated-orcid":false,"given":"Timoleon","family":"Siempis","sequence":"first","affiliation":[{"name":"Department of Otolaryngology James Paget University Hospital NHS Foundation Trust Great Yarmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4353-1277","authenticated-orcid":false,"given":"Zhu","family":"Yeap","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology James Paget University Hospital NHS Foundation Trust Great Yarmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2382-8199","authenticated-orcid":false,"given":"Shifa","family":"Ali","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-3236","authenticated-orcid":false,"given":"Carl M.","family":"Philpott","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology James Paget University Hospital NHS Foundation Trust Great Yarmouth UK"},{"name":"Norwich Medical School University of East Anglia Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"1","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S1473-3099(20)30332-7","article-title":"Assessment of WHO Antibiotic Consumption and Access Targets in 76 Countries, 2000\u201315: An Analysis of Pharmaceutical Sales Data","volume":"21","author":"Klein E. Y.","year":"2021","journal-title":"Lancet Infectious Diseases"},{"issue":"5","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1002\/lary.21550","article-title":"Regional and Specialty Variations in the Treatment of Chronic Rhinosinusitis","volume":"121","author":"Lee L. N.","year":"2011","journal-title":"Laryngoscope"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.fsc.2011.10.010","article-title":"Bacteriology and Antibiotic Resistance in Chronic Rhinosinusitis","volume":"20","author":"Manes R. P.","year":"2012","journal-title":"Facial Plastic Surgery Clinics of North America"},{"issue":"4","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2500\/105065898781390000","article-title":"Endoscopically Guided Cultures in Chronic Sinusitis","volume":"12","author":"Nadel D. M.","year":"1998","journal-title":"American Journal of Rhinology"},{"issue":"1","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/ACI.0b013e3282f4178f","article-title":"Role of Staphylococcal Superantigens in Upper Airway Disease","volume":"8","author":"Bachert C.","year":"2008","journal-title":"Current Opinion in Allergy and Clinical Immunology"},{"issue":"5","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.amjoto.2015.04.010","article-title":"Endoscopically\u2010Derived Bacterial Cultures in Chronic Rhinosinusitis: A Systematic Review","volume":"36","author":"Thanasumpun T.","year":"2015","journal-title":"American Journal of Otolaryngology"},{"issue":"7","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/alr.21505","article-title":"Biofilm\u2010Forming Bacteria and Quality of Life Improvement After Sinus Surgery","volume":"5","author":"Zhang Z.","year":"2015","journal-title":"International Forum of Allergy & Rhinology"},{"key":"e_1_2_12_9_1","first-page":"1","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2020","volume":"58","author":"Fokkens W. J.","year":"2020","journal-title":"Rhinology"},{"issue":"5","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"e10598","DOI":"10.1371\/journal.pone.0010598","article-title":"The Human Nasal Microbiota and \n Staphylococcus aureus\n Carriage","volume":"5","author":"Frank D. N.","year":"2010","journal-title":"PLoS One"},{"issue":"3","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"e9525","DOI":"10.1371\/journal.pone.0009525","article-title":"Screening for Staphylococcal Superantigen Genes Shows no Correlation With the Presence or the Severity of Chronic Rhinosinusitis and Nasal Polyposis","volume":"5","author":"Heymans F.","year":"2010","journal-title":"PLoS One"},{"issue":"7","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1097\/01.mlg.0000221954.05467.54","article-title":"Bacterial Biofilms on the Sinus Mucosa of Human Subjects With Chronic Rhinosinusitis","volume":"116","author":"Sanderson A. R.","year":"2006","journal-title":"Laryngoscope"},{"issue":"1","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.otc.2016.08.004","article-title":"Bacterial Pathogens and the Microbiome","volume":"50","author":"Vickery T. W.","year":"2017","journal-title":"Otolaryngologic Clinics of North America"},{"issue":"8","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1111\/all.14276","article-title":"The International Sinonasal Microbiome Study: A Multicentre, Multinational Characterization of Sinonasal Bacterial Ecology","volume":"75","author":"Paramasivan S.","year":"2020","journal-title":"Allergy"},{"issue":"5","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/j.jaci.2022.11.031","article-title":"Alterations of Nasal Microbiome in Eosinophilic Chronic Rhinosinusitis","volume":"151","author":"Liang Y.","year":"2023","journal-title":"Journal of Allergy and Clinical Immunology"},{"issue":"6","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"3085","DOI":"10.1007\/s00405-025-09376-y","article-title":"Distinct Inflammatory Patterns and Nasal Bacterial Dysbiosis in Uncontrolled Chronic Rhinosinusitis","volume":"282","author":"Zhang Y.","year":"2025","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1186\/s12879-018-3272-9","article-title":"Temporal Instability of the Post\u2010Surgical Maxillary Sinus Microbiota","volume":"18","author":"Koutsourelakis I.","year":"2018","journal-title":"BMC Infectious Diseases"},{"issue":"4","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/alr.21481","article-title":"Gram\u2010Negative Bacterial Carriage in Chronic Rhinosinusitis With Nasal Polyposis Is Not Associated With More Severe Inflammation","volume":"5","author":"Tabet P.","year":"2015","journal-title":"International Forum of Allergy & Rhinology"},{"issue":"6","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.jcf.2013.02.004","article-title":"P. aeruginosa\n In the Paranasal Sinuses and Transplanted Lungs Have Similar Adaptive Mutations as Isolates From Chronically Infected CF Lungs","volume":"12","author":"Ciofu O.","year":"2013","journal-title":"Journal of Cystic Fibrosis"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"595555","DOI":"10.3389\/fmicb.2020.595555","article-title":"Antibiotic Treatment for Chronic Rhinosinusitis: Prescription Patterns and Associations With Patient Outcome and the Sinus Microbiota","volume":"11","author":"Lux C. A.","year":"2020","journal-title":"Frontiers in Microbiology"},{"issue":"6","key":"e_1_2_12_21_1","first-page":"420","article-title":"Antibiotic Usage in Chronic Rhinosinusitis: Analysis of National Primary Care Electronic Health Records","volume":"57","author":"Hopkins C.","year":"2019","journal-title":"Rhinology"},{"issue":"6","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1177\/000348940811700608","article-title":"Assessment of Trends in Antimicrobial Resistance in Chronic Rhinosinusitis","volume":"117","author":"Bhattacharyya N.","year":"2008","journal-title":"Annals of Otology, Rhinology, and Laryngology"},{"issue":"4","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1002\/ohn.1122","article-title":"Microbiological Profiles and Patterns of Resistance in Patients With Sinus Infections After Endoscopic Sinus Surgery","volume":"172","author":"Adelman A. E.","year":"2025","journal-title":"Otolaryngology and Head and Neck Surgery"},{"issue":"10506","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1016\/S0140-6736(25)01248-6","article-title":"The Clinical Effectiveness of Clarithromycin Versus Endoscopic Sinus Surgery for Adults With Chronic Rhinosinusitis With and Without Nasal Polyps (MACRO): A Pragmatic, Multicentre, Three\u2010Arm, Randomised, Placebo\u2010Controlled Phase 4 Trial","volume":"406","author":"Philpott C.","year":"2025","journal-title":"Lancet"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70172","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.70172","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:00:47Z","timestamp":1791846047000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.70172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":23,"alternative-id":["10.1111\/coa.70172"],"URL":"https:\/\/doi.org\/10.1111\/coa.70172","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2025-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"coa.70172"}}