The aim of this work was to assess the commensal flora in the adult middle meatus. Thus, 139 samples were taken from subjects of both sexes, over 16 years of age, seen in the community or hospitalized for less than 72 hours for non-rhinological conditions. They had had no nasal or sinus conditions in the previous three months. One hundred and thirteen samples contained at least one aerobic or anaerobic bacterium. Fifty-nine samples yielded a single organism in culture. A maximum of five organisms were isolated from a given patient. These results show that the adult middle meatus contains a mixed commensal flora and should prove useful in interpreting endonasal swab cultures during acute and chronic sinus infection.
In a prospective study conducted over a six-month period, the relative yield of 721 routine cultures of stool from adult inpatients as a function of the time after hospital admission was assessed. Salmonella, Campylobacter, Shigella or Yersinia spp. were recovered from 10.9% (41/377) of patients within three days of hospitalization and from only 1.5% (5/344) after three days. However, a review of these patients' charts did not suggest nosocomial transmission but rather a delay in stool collection or asymptomatic carriage. Clostridium difficile was isolated with a high frequency in patients both within and after three days of hospitalization (10.3% and 10.2%, respectively). Thus, stool specimens from adults hospitalized for more than three days should not be cultured except for Clostridium difficile unless there are plausible clinical or epidemiological reasons to do so.
Urease-positive thermophilic campylobacters were isolated for the first time from the feces of two adults with diarrheal disease and from the appendix of a child with appendicitis. They were identified as Campylobacter laridis by a hybridization dot blot assay. Urease testing should be included in the tests used for the identification of campylobacters at the species level, even for those strains which are not of gastric origin.
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