This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (33)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • General Rhinology  • Paranasal Sinus Disease  • Alert me on articles by topic  Social Bookmarking   What's this?

Neil Bhattacharyya, MD; Lynn J. Kepnes, RNP

Arch Otolaryngol Head Neck Surg. 1999;125:1117-1120.

Objective  To determine the microbiology of recurrent sinus infections occurring in patients after endoscopic sinus surgery (ESS).

Design  Retrospective review of sinus cultures obtained over a 4-year period from a consecutive series of patients who underwent ESS.

Setting  An academic general otolaryngology practice.

Results  A total of 290 cultures were performed in 125 patients after ESS. The female-male ratio of cultures was 2.5:1 with an average patient age of 47.3 years. This group of patients represents 14.5% of 860 patients who underwent ESS during the same period. A total of 65 patients had 1 culture performed, and 60 patients had multiple cultures. Of the 290 culture specimens, 87 (30.0%) demonstrated no growth. Gram-positive cocci predominated, accounting for 37.9% of culture results. Gram-negative rods constituted 14.8% of the isolates. Of the cultures yielding gram-negative rods, 90.7% occurred in patients who had multiple cultures (P=.03). Fungal forms were cultured in 1.7% of the specimens. None of the Streptococcus pneumoniae isolates demonstrated penicillin-based resistance. The percentages of -lactamase–producing strains for Haemophilus influenzae and Branhamella (Moraxella) catarrhalis were 45.4% and 81.8%, respectively. Staphylococcal species also exhibited significant antibiotic resistance patterns, but no statistical association with multiple cultures was noted (P=.23).

Conclusions  A wide range of bacteria may be present in the infected post-ESS sinus cavity, with a considerable population of gram-negative organisms, including Pseudomonas species. -Lactamase–producing organisms continue to be prevalent in postoperative sinus infections. Culture and sensitivity analyses of pathologic secretions may identify drug-resistant organisms or organisms related to difficult-to-treat infections in exacerbations of chronic rhinosinusitis in the postoperative setting.

From the Division of Otolaryngology, Brigham and Women's Hospital (Dr Bhattacharyya and Ms Kepnes), and the Department of Otology and Laryngology, Harvard Medical School (Dr Bhattacharyya), Boston, Mass.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Risk of Development of Antimicrobial Resistance in Individual Patients With Chronic Rhinosinusitis
Bhattacharyya and Kepnes
Arch Otolaryngol Head Neck Surg 2004;130:1201-1204.
ABSTRACT | FULL TEXT  

Antimicrobial Treatment and Recurrent Rhinosinusitis
Ahmadizadeh et al.
Arch Otolaryngol Head Neck Surg 2000;126:690-690.
FULL TEXT