Chronic Rhinosinusitis and Obstructive Sleep Apnea: CPAP Reservoir Bacterial Colonization Is Not Associated with Sinus Culture Positivity

Chronic rhinosinusitis (CRS) and obstructive sleep apnea (OSA) are both highly prevalent chronic diseases in the United States. Association between culture positivity of CPAP machines and sinus samples has not been studied in patients with both disease states. Our objective was to compare the microbes present in the sinus cavities and CPAP reservoirs of patients with both CRS and OSA. Patients from an academic tertiary care Rhinology practice were identified with both CRS and OSA and enrolled prospectively. Inclusion criteria included age over 18 years; diagnosis of OSA by sleep study; regular CPAP use; and an active diagnosis of CRS. Exclusion criteria included treatment with antibiotics or cleaning of the CPAP reservoir in the month prior. Cultures were taken from participants’ sinus cavities and CPAP reservoirs and resulting microbial growth was compared. The most common organisms on CPAP culture were Enterobacter cloacae and Acinetobacter baumanii, whereas the most common on sinus culture were Staphyloccoccus aureus and Pseudomonas aeruginosa. Microbial growth from the sinus cavities and the CPAP reservoirs were not concordant in any of our patients. There is no association between bacterial colonization of the CPAP reservoir and the sinus cavities of those with CRS and OSA based on microbiologic cultures.