Hostname: page-component-5cf477f64f-zrtmk Total loading time: 0 Render date: 2025-04-04T07:23:58.762Z Has data issue: false hasContentIssue false
  • English
  • Français

Bacteriology of chronic purulent secretions in chronic rhinosinusitis

Published online by Cambridge University Press:  29 June 2007

Jean-Michel Klossek ,
Luc Dubreuil ,
Hervé Richet ,
Béatrice Richet  and
Patrice Beutter
Jean-Michel Klossek*
Affiliation:
Service ORL et chirurgie cervico-faciale, Hôpital Jean Bernard, Centre Hospitalo-Universitaire de Poitiers, BP 577, 86021 Poitiers Cédex, France.
Luc Dubreuil
Affiliation:
Laboratoire de Bactériologie, Faculté de Pharmacie, BP 83, 59045 Lille Cédex, France.
Hervé Richet
Affiliation:
Laboratoire de Bactériologies, Hôtel Dieu, Centre Hospitalo-Universitaire de Nantes, BP 10005, 44035 Nantes Cédex, France.
Béatrice Richet
Affiliation:
Laboratoire de Bactériologies, Hôtel Dieu, Centre Hospitalo-Universitaire de Nantes, BP 10005, 44035 Nantes Cédex, France.
Patrice Beutter
Affiliation:
Service ORL et chirurgie cervico-faciale, Hôpital Bretonneau, Centre Hospitalo-Universitaire de Tours, 37000 Tours, France.
*
Address for correspondence: Professor J. M. Klossek, Service ORL et Chirurgie cervicofaciale, Hôpital Jean Bernard CHU Poitiers, BP577 86021 Poitiers Cédex, France. Fax: (33)549443848
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this work was to study the bacterial flora of purulent secretions during chronic rhinosinusitis. We studied a total of 533 patients divided into two groups. The control population consisted of 139 adults (> 16 years) of both sexes seen in the community or hospitalized for less than 72 hours for non-rhinological conditions. The rhinosinusitis group consisted of 394 patients referred to the ENT clinic with chronic rhinosinusitis. All the patients with rhinosinusitis had had a post-nasal discharge for at least three months, associated with purulent or mucopurulent secretions originating from the involved sinus cavity. All samples were obtained endonasally under endoscopic guidance from the sinus ostium or from the sinus cavity during surgery. Cultures were positive in 81.3 per cent of the control subjects and 83.1 per cent of the patients with rhinosinusitis.

Corynebacteria, coagulase-negative staphylococci, propionibacteria and peptostreptococci were the main commensal organisms, while Haemophilus influenzae, streptococci, Streptococcus pneumoniae, Prevotella spp and Fusobacterium spp were probable causative pathogens. Anaerobes were isolated from approximately 25 per cent of the patients in the rhinosinusitis group. Betalactamase producers represented 27.5 per cent of H. influenzae and 28 per cent of Prevotella spp isolates. Diminished susceptibility to penicillin was found in 13 per cent of S. pneumoniae isolates. The amoxycillin-clavulanate combination was the most active oral antibiotic tested against the pathogenic species in vitro.

Keywords

RhinitisParanasal sinus diseasesInfectionBacteriology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 12 , December 1998 , pp. 1162 - 1166
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the meeting REESPIR Paris, 26–27 January 1995.

References

Almadori, G., Bastianini, F., Maurizi, M., Paludetti, G., Scuteri, F. (1986) Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis. Rhinology 24: 257–264.Google ScholarPubMed
Axelsson, A., Brorson, J. E. (1973) The correlation between bacteriological findings in the nose and maxillary sinus in acute sinusitis. Laryngoscope 83: 2003–2011.CrossRefGoogle Scholar
Brook, I. (1981) Aerobic and anaerobic bacterial flora of normal maxillary sinuses. Laryngoscope 91: 372–376.CrossRefGoogle ScholarPubMed
Brook, I., Thompson, D., Frazier, E. (1994) Microbiology and management of chronic maxillary sinusitis. Archives of Otolaryngology–Head and Neck Surgery 120: 1317–1320.Google ScholarPubMed
Dabernat, H., Delmas, C. (1996) Activité du Centre National de Référence pour Haemophilus influenzae, bilan 1994–1995. Les débuts de l'après vaccination. Medecine Maladie Infectieuses 26: 698–703.CrossRefGoogle Scholar
Davidson, T. M., Brahme, F. J., Gallagher, M. E. (1989) Radiographic evaluation for nasal dysfunction: computed tomography versus plain films. Head and Neck 11: 405–409.CrossRefGoogle ScholarPubMed
Erkan, M., Aslan, T., Ozcan, M., Koç, N. (1994) Bacteriology of antrum in adults with chronic maxillary sinusitis. Laryngoscope 104: 321–323.CrossRefGoogle ScholarPubMed
Gwaltney, J. M. Jr. (1995) Sinusitis. In Principles and Practice of Infectious Diseases 4th Edition. (Mandell, G. L., Bennett, J. E., Dolin, R., eds.) Churchill Livingstone, New York, pp 585–590.Google Scholar
Hartog, B., Degener, J. E., Van Benthem, G., Hordijk, G. J. (1995) Microbiology of chronic maxillary sinusitis in adults: Isolated aerobic and anaerobic bacteria and their susceptibility to 20 antibiotics. Acta Otolaryngologica (Stockh) 155: 672–677.CrossRefGoogle Scholar
Jousimies-Somer, H., Savolainen, S., Ylikoski, J. (1988) Macroscopic purulence, leucocyte counts and bacteriological morphotypes in relation to cultures findings for sinus secretions in acute maxillary sinusitis. Journal of Clinical Microbiology 26: 1926–1933.CrossRefGoogle Scholar
Jousimies-Somer, H., Savolainen, S., Ylikoski, J. (1989) Comparison of the nasal bacterial floras in two groups of healthy subjects and in patients with acute maxillary sinusitis. Journal of Clinical Microbiology 27: 2736–2743.CrossRefGoogle ScholarPubMed
Klossek, J. M., Dubreuil, L., Richet, B., Sedaillan, A., Beutter, P. (1996) Bacteriology of the adult middle meatus. Journal of Laryngology and Otology 110: 847–849.CrossRefGoogle ScholarPubMed
Loch, W. E., Allava, M., Paparella, M. (1990) Sinusitis. Primary Care 17: 323–334.CrossRefGoogle ScholarPubMed
Lund, V. J., Kennedy, D. W. (1995) Quantification for staging sinusitis. The Staging and Therapy Group. Annals of Otology, Rhinology and Laryngology – Supplement (167): 17–21.CrossRefGoogle ScholarPubMed
Lundberg, C., Engquist, S. (1984) Localization of bacteria and the cause of tissue destruction in maxillary sinusitis. Acta Otolaryngologica (Stockh) S407: 30–32.CrossRefGoogle Scholar
Rowe-Jones, J., Mackay, I. (1995) Sinusitis and rhinitis or rhinosinusitis? British Medical Journal 310: 610 (Letter).CrossRefGoogle ScholarPubMed
Savolainen, S., Ylikoski, J., Jousimies-Somer, H. (1987) Predictive value of nasal bacterial culture for etiological agents in acute maxillary sinusitis. Rhinology 28: 49–55.Google Scholar
Savolainen, S., Ylikoski, J., Jousimies-Somer, H. (1989) Differential diagnosis of purulent and non-purulent acute maxillary sinusitis in young adults. Rhinology 27: 53–61.Google ScholarPubMed
Sobin, J., Engquist, S., Nord, C. E. (1992) Bacteriology of the maxillary sinus in healthy volunteers. Scandinavian Journal of Infectious Diseases 24: 633–635Google ScholarPubMed
Su, W. Y., Liu, C., Hung, S. Y., Tsai, W. F. (1983) Bacteriological study in chronic maxillary sinusitis. Laryngoscope 93: 931–934.CrossRefGoogle ScholarPubMed
Suzuki, K., Nishiyama, Y., Sugiyama, K., Miyamoto, N., Baba, S. (1996) Recent trends in clinical isolates from paranasal sinusitis. Acta Otolaryngologica (Suppl 525): 51–55.Google ScholarPubMed
Van Cauwenberge, P. B., Van der Mijnsbrugge, A. M., Ingels, K. J. A. O. (1993) The microbiology of acute and chronic sinusitis and otitis media: a review. European Archives of Otorhinolaryngology 250: S3–6.CrossRefGoogle ScholarPubMed