Microbiologic Study of Chronic Sinusitis in Children

Choi, Young Chul; Kim, Tae Chul; Jeon, Eun Ju; Park, Yong Soo

Abstract

BACKGROUND AND OBJECTIVES: The microbiology of chronic sinusitis in children can be anticipated according to the patient's age, clinical presentation, and immunologic state. In acute stage, viral upper respiratory infections frequently precede bacterial superinfection by Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis. In contrast to acute sinusitis, alpha-hemolytic Streptococcus, coagulase negative Staphylococcus and Staphylococcus aureus are common in chronic sinusitis, which may be caused by exacerbations of infection with the bacterial species that cause acute disease. The use of empiric antibiotics directed at the most offending organism is usually appropriate and effective in clinical situation. But the emergency and increasing occurrence of antibiotic resistance has increased the failure rate. MATERIAL AND METHODS: In this prospective study, 50 patients with the diagnosis of chronic sinusitis were evaluated microbiologically by Sinoject (Atos, Sweden) guided aspiration.
RESULTS
We cultured alpha-hemoltic Streptococcus in 14 patients, coagulase negative Staphylococcus in 4 patients, Staphylococcus aureus in three patients, gram-positive bacilli in two patients, Streptococcus pneumoniae in one patient. The results of PCR for Hemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis were 32%, 20%, 10%, respectively, and it showed higher detection rates than conventional culture test.
CONCLUSION
We advise that all bacterial isolates of cultures of chronic sinusitis in children should undergo appropriate typing and antibiotic sensitivity tests so that the appropriate antibiotic treatment may be employed.