Acute paranasal sinusitis related to nasotracheal intubation of head-injured patients

Pathogens responsible for concurrent sinusitis and pneumonia in intensive care unit patients

“…This number is higher than that (32%) recently reported by Rouby et al [6], probably because these authors performed quantitative cultures and required a threshold of 103 CFU/ml for defining sinusitis. As previously reported [2][3][4][5]8], the predominant pathogens were Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacteriaceae, whereas Haemophilus influenzae and streptococci were less frequently isolated (Table 1 ). Yeasts were common but always associated with bacteria.…”

“…It is often associated with nosocomial pneumonia, with the same pathogen cultured from sinus and bronchopulmonary samples in most cases [2,3]. Salord et al [4] reported that the incidence of pneumonia was significantly higher in patients with sinusitis (14/26, 54%) than in those without sinusitis (4/85, 5%).…”

“…Furthermore, these bacteria, as well as A. baumannii, are producers of a glycocalyx, that effects their adhesion to biomaterials such as polyvinylchloride, a common constituent of endotracheal tubes [11]. Treatment of nosocomial sinusitis is still controversial and may include removal of the nasal tubes, topical nasal decongestants, sinus drainage and lavage, and administration of systemic antibiotics based on susceptibility studies [2,[4][5][6]. Our findings suggest that patients with sinusitis due to S. aureus, A. baumannii and P. aeruginosa are at higher risk of developing pneumonia than those with sinusitis due to other pathogens.…”

Paranasal Sinusitis Associated With Nasotracheal and Orotracheal Long-term Intubation

“…This demonstrates that the mechanical obstruction of the si¬ nus ostia by the nasal tube and the conditions in ICU patients lead to the dynamic process with edema, di¬ minished mucociliary cleansing of the sinus cavity, pro¬ liferating sinus flora, and inflammation. [2][3] Conditions in critically ill patients are important factors for the development of nosocomial sinusitis, but the nasotracheal tube can be seen as an additional risk.…”

Practice Guidelines for Evaluating New Fever in Critically Ill Adult Patients

“…Gram-positive bacteria cfu/mL and that pyuria is almost always present in nonneutrocomprise one-third of the isolates (S. aureus is the most compenic patients. mon), whereas fungi comprise the remaining 5% -10% of isoAlthough it is appropriate to collect urine specimens in the lates [65,66,68,69]. investigation of fever, routine monitoring or surveillance cultures of urine contribute little to patient care [63].…”