Identification of bacterial contaminants in sinus irrigation bottles from chronic rhinosinusitis patients

Objective: To determine if sinus irrigation bottles from patients with chronic rhinosinusitis (CRS) harbour bacterial contaminants. Design: Patients with symptoms of CRS who showed no mucopurulent infection and had no history of surgery were enrolled in the study. Patients were instructed on the proper use and cleaning of sinus irrigation bottles and were asked to return their rinse bottle during follow-up visits. Methods: Bacterial contaminants were cultured from the inner surface of the sinus irrigation bottles obtained from patients. Genomic deoxyribonucleic acid (DNA) was isolated from purified colonies and used to polymerase chain reaction (PCR) amplify the 16S ribosomal ribonucleic acid (rRNA) genes. PCR products were sequenced and analyzed in the Human Oral Microbiome Database (HOMD) for genus and species identification based on 16S ribosomal DNA (rDNA) sequence comparisons. Main Outcome Measures: The outcomes included the recovery of bacterial contaminants and their subsequent identification. Results: In total, 142 bacterial isolates were cultured and identified. The organisms included known oral flora bacteria, as well as pathogens of the upper respiratory tract and sinuses. Thirty-two different bacterial species were identified from 11 patients. There was no correlation between the length of bottle use and the degree of contamination. Conclusion: This study highlights the risk of bacterial contamination of sinus irrigation bottles and the potential for patient reinoculation.