Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2025; 16(7): 104970
Published online Jul 15, 2025. doi: 10.4239/wjd.v16.i7.104970
Analysis of nasal secretion culture results in diabetic patients with chronic rhinosinusitis and factors influencing postoperative recurrence
Xing Liu, Qian-Qian Wang, Shou-Yan Qiao, Xiao-Ning Zhu
Xing Liu, Qian-Qian Wang, Shou-Yan Qiao, Xiao-Ning Zhu, Department of Otolaryngology, Qingdao Traditional Chinese Medicine Hospital, Qingdao Hiser Hospital Affiliated of Qingdao University, Qingdao 266071, Shandong Province, China
Co-first authors: Xing Liu and Qian-Qian Wang.
Author contributions: Liu X wrote the manuscript; Liu X and Zhu XN reviewed the manuscript; Liu X, Wang QQ and Qiao SY collected the data; and all authors annotated the manuscript. Liu X and Wang QQ contributed equally to this work as co-first authors.
Institutional review board statement: This study was approved by the Ethic Committee of Qingdao Traditional Chinese Medicine Hospital, Qingdao Hiser Hospital Affiliated of Qingdao University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Data used in this study are available from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Ning Zhu, Department of Otolaryngology, Qingdao Traditional Chinese Medicine Hospital, Qingdao Hiser Hospital Affiliated of Qingdao University, No. 4 Renmin Road, Shibei District, Qingdao 266071, Shandong Province, China. 17657168769@163.com
Received: February 26, 2025
Revised: April 25, 2025
Accepted: May 28, 2025
Published online: July 15, 2025
Processing time: 139 Days and 1.3 Hours
Abstract
BACKGROUND

In diabetic patients, persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria, resulting in severe complications. Consequently, chronic rhinosinusitis (CRS) complicated by diabetes is highly prevalent in clinical settings.

AIM

To analyze the results of nasal secretion cultures in diabetic patients with CRS and identify the factors influencing postoperative recurrence.

METHODS

A retrospective analysis was conducted on the clinical data of 203 diabetic patients with CRS with nasal polyps who underwent the Messerklinger technique at Qingdao Hiser Hospital Affiliated of Qingdao University between January 2021 and January 2023. Preoperative nasal secretions were cultured to determine the types and distribution of pathogenic bacteria and assess antimicrobial susceptibility. Based on a one-year follow-up, patients were categorized into recurrence and nonrecurrence groups to analyze differences in their clinical data. Univariate and multivariate analyses were used to identify factors influencing postoperative recurrence.

RESULTS

Pathogens were detected in 153 of the 203 nasal secretion specimens collected from diabetic patients with CRS. A total of 134 pathogenic bacteria strains were isolated and identified, including 81 strains (60.4%) of gram-positive bacteria and 53 strains (39.6%) of gram-negative bacteria. Gram-positive bacteria exhibited relatively high resistance to penicillin G and erythromycin, while remaining highly sensitive to vancomycin, gentamicin, and rifampicin. Gram-negative bacteria demonstrated relatively high resistance to cefazolin and gentamicin, but showed high sensitivity to imipenem, meropenem, cefepime, and ceftazidime. Univariate analysis revealed statistically significant differences between the recurrence and nonrecurrence groups in fasting blood glucose levels, smoking history, Lund-Mackay scores, visual analog scale (VAS) scores, nasal septum deviation, allergic rhinitis, bronchial asthma, postoperative infection, long-term use of nasal decongestants, and adherence to medical prescriptions. Multivariate regression analysis identified fasting blood glucose levels and VAS-measured nasal symptom severity scores as independent factors influencing postoperative recurrence.

CONCLUSION

In CRS patients with nasal polyps (CRSwNP), the detection rate of nasal pathogens is relatively high, and most of the isolated bacteria exhibit antimicrobial resistance. Additionally, the blood glucose level of patients with CRS combined with CRSwNP is a risk factor for postoperative recurrence.

Keywords: Diabetes; Chronic rhinosinusitis; Nasal secretions; Pathogen; Postoperative recurrence

Core Tip: Chronic rhinosinusitis (CRS) is a common clinical condition in patients with diabetes, and is associated with environmental factors and reduced host immunity. It not only impairs normal nasal function but may also cause the spread of infection to intracranial tissues, worsening the patient’s condition. Therefore, timely surgical intervention is essential. This study examined the nasal secretion culture results in diabetic patients with CRS and identified key factors influencing postoperative recurrence.