Microbiological profile in chronic rhinosinusitis patients in a rural hospital of India
Keywords:Chronic rhinosinusitis, Microbiology, Staphylococcus, Aspergillus, Functional endoscopic sinus surgery
Background: Chronic rhinosinusitis is one of the most common health problem a detailed microbiological profile of which is necessary to guide its proper management. The aim of this study was to identify the microbial pattern present in chronic rhinosinusitis (CRS) patients undergoing functional endoscopic sinus surgery at a rural tertiary care hospital in India.
Methods: A prospective study was done in ENT department of MGIMS, Sewagram over a period of 2 years. A total of 94 patients were included in the study. They were clinically diagnosed to have chronic sinusitis and confirmation was done by CT imaging of paranasal sinuses. During FESS, sinus secretions were aspirated and were subjected to bacterial and fungal culture. Bacterial and Fungal pathogens were identified according to the standard protocol.
Results: In the 94 patients, the mean age was 33.44 years and Male female ratio was 1.08: 1. Staphylococcus was the commonest organism isolated in 54 cases (57.4%) followed by Streptococcus pneumoniae in 5 cases (5.3%), Klebsiella in 1 case (1.1%), E.coli in 1 case (1.1%) and Pseudomonas aerogenosa in 1 case (1.1%).Fungus (Aspergillus niger) was isolated in 2 patients (2.1%) and no pathogens were found in 30 (31.9%) patients.
Conclusions: In CRS bacterial etiology is the commonest.
Benninger MS, Ferguson BJ, Hadley JA, Hamilos DJ, Jacobs M, Kennedy DW, et al. Adult chronic rhinosinusitis: Definitions, diagnosis, epidemiology & pathophysiology. Otolaryngol Head Neck Surg. 2003;129:1-32.
Gliklich RE, Metson R.The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg. 1995;113(1):104-9.
Kaliner MA, Osguthorpe JD, Fireman P, Anon J, Georgitis J, Davis ML, et al. Sinusitis: bench to bedside. Current findings, future directions. Otolaryngol Head Neck Surg. 1997;116(6):1-20.
BlackwelI DL, Collins JG, Coles R. Summary health statistics for US adults: National Health Interview Survey. Vital Health Stat. 2002;10:205.
Schappert SM, Burt CW. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 2001-02. Vital Health Stat. 2006;13(159):1-66.
McCaig LF, Hughs JM. Trends in antimicrobial drug prescribing among office –based physician in the United States. J Am Med Assoc. 1995;273:214-9.
Klossek JM, Dubreuil L, Richet H, Richet B, Beutter P. Bacteriology of chronic purulent secretions in chronic rhinosinusitis. J Laryngol Otol 1998,112:1162–6.
Jiang RS, Jang JW, Hsu CY. Bacteriology of chronic sinusitis after amoxicillin-clavulanate potassium therapy. Otolaryngol Head Neck Surg. 2001;124:683–6.
Meltzer EO, Hamilos DL, Hadley JA, Lanza DC, Marple BF, Nicklas RA, et al. Rhinosinusitis: Establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg 2004;131(6):1-62.
Mortimore S, Wormald PJ. The Groote Schuur hospital classification of the orbital complications of sinusitis. J Laryngol Otol. 1997;111(8):719-23.
Biel MA, Brown CA, Levinson RM, Garvis GE, Paisner HM, Sigel ME, et al. Evaluation of the microbiology of chronic maxillary sinusitis. Ann Otol Rhinol Laryngol. 1998,107:942–5.
Nadel DM, Lanza DC, Kennedy DW. Endoscopically guided cultures in chronic sinusitis. Am J Rhinol. 1998;12:233–41.
Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101:56-64.
Keech DR, Ramadan H, Mathers P: Analysis of aerobic bacterial strains found in chronic rhinosinusitis using the polymerase chain reaction. Otolaryngol Head Neck Surg. 2000;123:363–7.
Rombaux P, Gigi J, Hamoir M, Eloy P, Bertrand B, Bacteriology of chronic sinusitis: the bulla ethmoidalis content. Rhinol. 2002;40(1):18-23.