Noninvasive in vivo optical detection of biofilm in the human middle ear
Noninvasive in vivo optical detection of biofilm in the human middle ear
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DOI：
10.1073/pnas.1201592109
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发表时间：
2012-06-12
影响因子：
11.1
通讯作者：
Boppart, Stephen A.
中科院分区：
文献类型：
--
作者：
Nguyen, Cac T.;Jung, Woonggyu;Boppart, Stephen A.
中耳炎（OM）是一种中耳感染，是儿科医生治疗的最常见的儿童疾病。如果治疗不当，OM会导致长期的慢性问题，一直持续到成年。患有慢性OM或复发性OM的儿童通常有传导性听力损失和沟通困难，需要手术治疗。鼓膜造瘘管插入，在鼓膜（TM）中放置一根小引流管，是全麻下儿童最常见的外科手术。最近的临床研究表明，慢性OM与中耳内细菌生物膜的存在有直接的对应关系。生物膜通常非常薄，不能用常规耳镜识别。在这里，我们报告使用光学相干测距技术来无创评估中耳，以检测和量化生物膜微观结构。本研究涉及成人慢性OM，这通常被认为是一种与生物膜相关的疾病。以临床表现为金标准，对13名临床感染患者和7名正常对照者进行了超过18537次光学测距扫描和742张图像，所有慢性OM的中耳都显示出生物膜的证据，而所有正常耳都没有。关于生物膜的存在及其结构和对抗生素治疗的反应的信息，不仅可以更好地了解中耳生物膜的形成、生长和根除，而且还可以提供急需的量化数据，以便对慢性OM的中耳生物膜进行早期检测和定量纵向治疗监测。
Otitis media (OM), a middle-ear infection, is the most common childhood illness treated by pediatricians. If inadequately treated, OM can result in long-term chronic problems persisting into adulthood. Children with chronic OM or recurrent OM often have conductive hearing loss and communication difficulties and require surgical treatment. Tympanostomy tube insertion, the placement of a small drainage tube in the tympanic membrane (TM), is the most common surgical procedure performed in children under general anesthesia. Recent clinical studies have shown evidence of a direct correspondence between chronic OM and the presence of a bacterial biofilm within the middle ear. Biofilms are typically very thin and cannot be recognized using a regular otoscope. Here we report the use of optical coherent ranging techniques to noninvasively assess the middle ear to detect and quantify biofilm microstructure. This study involves adults with chronic OM, which is generally accepted as a biofilm-related disease. Based on more than 18,537 optical ranging scans and 742 images from 13 clinically infected patients and 7 normal controls using clinical findings as the gold standard, all middle ears with chronic OM showed evidence of biofilms, and all normal ears did not. Information on the presence of a biofilm, along with its structure and response to antibiotic treatment, will not only provide a better fundamental understanding of biofilm formation, growth, and eradication in the middle ear, but also may provide much-needed quantifiable data to enable early detection and quantitative longitudinal treatment monitoring of middle-ear biofilms responsible for chronic OM.