Isolates of Bacteria and Their Sensitivity to Antibiotics in Fungal Maxillary Sinusitis

Lee, Yoon Sik; Kim, Yong Jae; Kim, Jae Ho; Jung, Yu Sam; Lee, Bong Jae

Abstract

BACKGROUND AND OBJECTIVES: In patients with fungal sinusitis, purulent discharge from the maxillary sinus is frequently observed and it responds to antibiotic treatment. Even though fungal sinusitis is resolved after surgery, the purulent discharge continues in some cases. We aimed to identify the pathogens of the purulent discharge in fungal sinusitis and to obtain information for appropriate antibiotics through a sensitivity test. MATERIALS AND METHOD: Among 71 patients with fungal sinusitis of the maxillary sinus, purulent secretions were found in 44 patients (62%) during an endoscopic sinus surgery. Endoscope-guided collection of the maxillary sinus secretions were performed and specimens were sent to the laboratory for bacterial cultures and antibiotic sensitivity tests.
RESULTS
Among 44 cases with fungal lesions and purulent secretion in the maxillary sinus, bacteria were isolated in 27 cases (61.4%). Gram (+) aerobes were recovered in 19 cases, and Gram (-) aerobes were recovered in 16 cases. Mixed infection by Gram (+) and Gram (-) bacteria were observed in 8 patients. Anaerobic bacteria were not isolated. Among the Gram (+) aerobes, S. aureus was the most common organism (8 cases), while Enterobacter aerogenes was the most common organism (7 cases) of the Gram (-) aerobes. In an antibiotic sensitivity test for Gram (+) bacteria, ciprofloxacin, vancomycin, and teicoplanin showed sensitivity over 85 %. For Gram (-) bacteria, ceftazidime, ciprofloxacin, ticarcillin, tobramycin, and imipenem showed sensitivity over 90%.
CONCLUSION
In patients with fungal sinusitis, concomitant bacterial infections are identified in more than half of the cases. Thus, postoperative administration of appropriate antibiotics can be justified in the treatment of fungal sinusitis.