Professor Psaltis has 202 peer-reviewed publications
Allergy. 2021 Apr 30. doi: 10.1111/all.14883. Online ahead of print.
Staphylococcus aureus is a pathogen of major concern in both acute infections as well as chronic conditions such as chronic rhinosinusitis (CRS). Bacteriophage (phage) therapy has been considered in Western countries as early as the 1920s and has recently regained interest for its potential to treat infections caused by antibiotic resistant strains including Methicillin Resistant Staphylococcus aureus (MRSA). However, bacteria can adapt and become resistant to phages. The ability to overcome phage resistance is considered critically important for phage therapy applications. Here we show that sub-inhibitory concentrations of Protein Synthesis Inhibitor (PSI) antibiotics clindamycin, erythromycin and azithromycin could sensitise phage-resistantS. aureus strains to phages in vitro and in vivo. All 3 antibiotics showed synergy when combined with multiple lytic phages against 9 S. aureus clinicalisolates in planktonic growth and 2 strains forming biofilms. The combination of clindamycin and phages was safe and could eradicate S. aureussinonasal biofilms in a murine model of sinusitis. This data supports the potential use of phage-PSI antibiotic combination therapies in particular for difficult to treat infections with phage-resistantS. aureus and MRSA strains.
Int Forum Allergy Rhinol. 2020 Nov 24. doi: 10.1002/alr.22741. Online ahead of print.
BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document.
METHODS: ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary.
RESULTS: ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided.
CONCLUSION: This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS. This article is protected by copyright. All rights reserved.
Rhinology. 2020 Jul 21. doi: 10.4193/Rhin20.055. Online ahead of print.
BACKGROUND: Oral and topical corticosteroids, and antibiotics form the mainstay medical treatment of chronic rhinosinusitis (CRS). Clinical outcomes vary depending on the chosen therapy, resident microbiome and disease phenotype. We conducted a double- blinded, placebo-controlled Randomised Controlled Trial (RCT) to investigate effects of medical therapy on clinical outcomes and associated microbiome shifts.
METHODOLOGY: Fifty eligible patients (CRS with and without polyps) were treated for 3 weeks after randomisation into 3 arms: na- mely oral prednisolone, topical budesonide irrigations and oral doxycycline; each with appropriate placebo. Clinical scoring and microbiome swabs were performed on enrolment, at treatment completion and 3-weeks post treatment completion. Microbiome analysis was performed using the llumina-MiSeq next generation sequencing platform and QIME-2 pipeline.
RESULTS: Significant improvement in clinical scores was observed in prednisolone and budesonide arms at treatment completion but not with antibiotic. Sub-group analysis showed more pronounced effects in patients with polyposis. Corynebacterium and Staphylococcus species predominated, with variable bacterial relative abundance among different treatments at all time-points. The only significant microbiome finding was an increase in bacterial diversity in topical budesonide group immediately after treatment, which returned to baseline 3-weeks post treatment.
CONCLUSION: Clinical improvement was significant with oral and topical steroid but not empirical antibiotic. Although there were some associated microbiome changes with the various treatments, we could not ascertain the consistency of these and whether they do have a clinical significance at all.
Ear Nose Throat J. 2016 Mar;95(3):E19-27.
J Otolaryngol Head Neck Surg. 2010 Jun;39(3):217-31.