Complications of inflammatory sinusitis in children: institutional review

Microbiology of acute complicated bacterial sinusitis at the University of the Witwatersrand

“…Negative culture rates are a measure of prior antibiotic consumption, specimen handling and laboratory standards, and may vary widely from 0% to above 50%. 6,12 In this study, the negative culture rate of 27.9% is comparable to that encountered in similar studies. 2,4,11 Recent publications mention S. milleri as being the most common pathogen in patients with complicated sinusitis.…”

“…This is in keeping with the universal acceptance of this organism as a major pathogen. [3][4][5][6][7][8]11,14,15 H. influenzae (8.6%) and coagulase-negative staphylococci (8.6%) ranked joint third. H. influenzae occurred more frequently in children than in adults (Table II).…”

“…Previous studies cite wide variations, of between 2.8% and 26%, in the incidence of positive isolates of H. influenzae in complicated sinusitis. 1,2,[4][5][6]12 Equivalent studies attach no importance to H. influenzae as a pathogen. 3,8,11,13 Coagulase-negative staphylococci have long been regarded as non-pathogenic, but in a recent study their role as important pathogens is recognised.…”

“…In medical literature the aerobic species cited as being among the most prevalent include S. aureus, 3,6,7,[11][12][13] H. influenzae, 1,2,6,9 S. milleri, 4,5 S. pneumoniae, 2,9,12 S. viridans 3,6 and M. catarrhalis. 2,9 The most frequently reported anaerobes include Peptostreptococcus, Prevotella, Fusobacterium, Propionibacterium and Bacteroides.…”

“…The notable absence of S. milleri as seen at JH is also reported by other authors. 3,6,7,[11][12][13] Lancefield group A, C, F and G β-haemolytic streptococci (10.8%) were isolated at both hospitals. Group C, with 11 isolates, had the highest count, followed by groups A and F, then finally by group G ( Table I).…”