ENT | Chronic Sinusitis and Other ENT Infections

Diagnosing and Managing CRS and CSOM with qPCR+NGS

qPCR+NGS: The emerging gold standard for sinus and ear infection testing

Microbial dysbiosis contributes to acute exacerbations among CRS patients. Compared to molecular testing, culture can identify less than 30% of the dominant species in CRS patient samples. Traditional culture offers low cost for single aerobic isolation, but low sensitivity beyond a few common microbes. For polymicrobial infections such as CRS and CSOM, qPCR+NGS affords high sensitivity and low cost combined, regardless of the isolates detected.

What qPCR+NGS reveals may surprise you. Based on approximately 80,000 sinus and ear samples processed by MicroGenDX, >86% of specimens are polymicrobial, >50% contain anaerobes, and >20% contain fungi – all of which are costly and time-consuming microbes for culture to isolate.

If you want to provide personalized, effective antimicrobial management for your patients – leading to faster recovery and higher patient satisfaction – give us a call. MicroGenDX offers you consistent and proven speed, accuracy, and affordability for diagnosing and managing challenging sinus and ear infections. View case studies

Traditional Culture	MicroGenDX qPCR+NGS
Underestimates anaerobes, fungi, and fastidious organisms Unable to detect dominant pathogen in CRS some 69.5% of the time Unable to detect biofilms or viable but nonculturable bacteria (VBNC) Often leads to mixed flora results that offer little guidance for treatment	Reliably detects all bacteria and fungus present in each sample Matches DNA to 50,000+ species of microbes in curated database 99.2% accuracy, listing species by relative abundance
Susceptibility represents single bacterium’s resistance – not enhanced resistance of in vivo community (polymicrobial/biofilm)	Up to 17 antimicrobial resistance genes detected represent in vivo resistance potential of entire community (polymicrobial/biofilm)
Constrained by transportation protocols, growth media, culture preparation, and growth conditions Highly variable turnaround for different bacteria, and up to four weeks for fungi	Guaranteed results with sufficient DNA, and minimally affected by transport time or temperature Rapid return of most comprehensive results – qPCR in 24-48 hours, NGS in 3.5 days, for all species
Costly for polymicrobial, anaerobic, or fungal isolations	Same low cost per patient/incident, regardless of the number of microbes detected

References

Hauser L J, Feazel L M, et al. Sinus culture poorly predicts resident microbiota. Internal Forum of Allergy & Rhinology. 2015 Jan;5(1):3-9. doi: 10.1002/alr.21428
Data on file for MicroGenDX sampling results statistics

Show References

Culture misses the pathogens that qPCR+NGS detects

Results from over 80,000 ENT samples processed by MicroGenDX qPCR+NGS:

850 species of anaerobes and fungi played a dominant role in any given sample
Anaerobes were present in 45% of samples, and dominant in 12%
Fungi were present in 22% of samples
In a small percentage of samples, those dominant species were commonly-known CRS pathogens, including
- Staph aureus: 11% of samples
- Pseudomonas aeruginosa: 8%
- Haemophilus influenzae: 4%

Identifying a more complete picture of microbiota is helpful for all infections, but especially critical for recalcitrant infections such as CSOM and CRS.