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KMID : 0900220060130020107
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대한비과학회지
2006 Volume.13 No. 2 p.107 ~ p.114
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Bacteriological Findings and Antimicrobial Susceptibility in Chronic Sinusitis with Nasal Polyp
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Abstract
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Background and Objectives: Microbiologic data in chronic sinusitis with nasal polyps, which is the foundation of proper antibiotic treatment, is insufficient due to problems with sampling and culture technique. Therefore, the objective of this study is to identify the causative agents in chronic sinusitis with nasal polyps based on culture results in adults and children and the relationship between the results of the middle meatus and maxillary sinus.
Materials and Method: Samples were obtained with middle meatus swabs and endoscopically guided maxillary sinus aspirations and then transferred to a microbiology laboratory using different media for aerobic and anaerobic cultures.
Results: Eighty one samples were studied. Sixty six from the middle meatus and sixty four from the maxillary sinus bacterial isolates were recovered. The most frequently isolated aerobic organisms were the Staphylococcus, Haemophilus influenza and Streptococcus while those of the anaerobic organisms in adults were the Prevotella and Peptostreptococcus. No anaerobic microorganisms were isolated in the children. Concordance rates of aerobic bacteria were 75.4% among adults and 90.0% among children. That of anaerobic bacteria was 83.6% among adults and 100% among children between the middle meatal swab and the maxillary sinus aspiration.
Conclusion: Authors recommend amoxacillin/clavulanate, cephalosporins and macrolide as the first-line medical treatment. In cases where there are no improvement of symptoms, cultures should be taken from the middle meatus, followed by appropriate selection of second-line antibiotics according to the sensitivity test results.
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