Bacteriology of the Maxillary Sinuses in Patients with Cystic Fibrosis

Abstract

The maxillary sinuses of 20 patients (median age, 15 years) with cystic fibrosis were examined with ultrasound, radiography, and transantral sinus aspiration (14 bilateral and six unilateral for a total of 34 aspirates). The sinus aspirations were performed with careful sterile techniques, and the material that was recovered was cultured quantitatively for both aerobic and anaerobic bacteria. Nineteen (95%) of the 20 patients had at least one positive (greater than or equal to 10(4) colony-forming units/ml) culture of sinus aspirate. The organisms most commonly recovered from the sinus aspirates were Pseudomonas aeruginosa (13), Haemophilus influenzae (10), streptococci (five), and anaerobes (five). There was no association between the bacterial species recovered from the sinus and the predominant bacterial species in the nasopharyngeal, throat, or sputum culture. Although most patients had been chronically receiving therapeutic oral doses of antimicrobial agents, bacteria sensitive to the antimicrobial agents that the patient had been taking (excluding P. aeruginosa) were recovered from the sinuses of nine of these 10 patients.

Sinus Bacteriology in Patients with Cystic Fibrosis or Primary Ciliary Dyskinesia: A Systematic Review

“…In four studies, 14,16,25,33 it was unclear whether the patients received antibiotics before or during sampling. Fifty percent of the studies 10,11,13,14,17,[22][23][24][26][27][28][29][30][31][32][33]36,38,39,42,45,47,49 provided information about culture methods. Most studies 10,11,14,17,[22][23][24][27][28][29][30][31][32]38,39,42,45,47,49 used conventional culture methods (41%).…”

“…Most studies 10,11,14,17,[22][23][24][27][28][29][30][31][32]38,39,42,45,47,49 used conventional culture methods (41%). In four studies, 22,35,37,40 the method applied was unclear (referred to other articles, "microbiologic examination," or "bacteriologic examination"). However, molecular methods (e.g., PCR) were applied in 26%.…”

The role of antibiotics in pediatric chronic rhinosinusitis

“…The commonest bacterial pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis . If the bacterial ARS does not dissipate, members of the anaerobic oropharyngeal flora and Staphylococcus aureus emerge as a pathogens 2, 8, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25…”

“…Aerobic gram‐negative bacilli such as Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter spp, Proteus mirabilis, and Escherichia coli , have been recovered in CRS, mostly in those with underlying medical conditions such as cystic fibrosis (in the case of Pseudomonas) or diabetes, and in the immunocompromised (neutropenia, critical illness, diabetes mellitus, or HIV) 23, 24, 25…”

Rhinosinusitis in children

“…Segundo um estudo de Luntz & Lusk, realizado em crianças submetidas a cirurgia sinusal, as culturas de etmoide isolaram 23% de Streptococcus alpha hemolítico e 19% de Staphylococcus aureus, e 30% das culturas apresentaram crescimento de múltiplos organismos 21 . Em crianças portadoras de mucoviscidose, os poucos estudos realizados mostram a Pseudomonas aeruginosa como o microorganismo mais prevalente nos aspirados de seios paranasais 22 .…”