Microbiology and antimicrobial resistance in chronic resistant rhino sinusitis with or without polyp after functional endoscopic sinus surgery
Abstract
Background: The purpose of this study was microbiology of chronic resistant rhino sinusitis with or without nasal polyp in patients undergoing functional endoscopic sinus surgery and antimicrobial resistance testing.
Patients and Methods: In a cross-sectional study during December 2000 to June 2002, 94 CRS patients with or without nasal polyp were sampled through FESS for microbiology culture and In-vivo antimicrobial resistance was tested in both groups.
Results: In CRS group with polyps (42 patients), the most common isolated organisms were Staph. coagulase-negative (26.2%), Staph. areous (23.8%), E-Coli (16.7%), Klebsiella (14.3%) and Enterobacter (7.1%). In CRS group without polyps (52 patients), the most common isolated organisms were Staph. coagulase-negative (25%), Staph. areous (11.5%), Klebsiella (9.6%), E-Coli (7.7%) and Strep. Non-group A (7.7%). Normal flora grew in 5 cultures (9.6%). In only one culture of CRS group without polyp, Pseudomonas was isolated. No resistance was reported from gram-positive bacteria against vancomycin and gram-negative rods were sensitive to ciprofloxacin, ceftriaxon and ceftizoxim.
Conclusion: Despite of some previous studies, the most common micro- organisms in the cultures of CRS cases, regardless of having nasal polyps or not, were Staph. coagulase-negative, Staph. aureus and gram-negative rods, respectively. The incidence of GNRs in CRS group with nasal polyps is higher which may lead to special antibiotic therapy in them. Increasing In Vivo resistance of these bacteria to antibiotics is problematic and the routine old antimicrobial therapy may not be effective enough to control these pathogens and avoid surgical therapy. However, In Vivo evaluations are recommended to reveal a better interpretation.
Key words: Chronic Resistant Rhino Sinusitis-Polyp-Endoscopic Sinus Surgery
Patients and Methods: In a cross-sectional study during December 2000 to June 2002, 94 CRS patients with or without nasal polyp were sampled through FESS for microbiology culture and In-vivo antimicrobial resistance was tested in both groups.
Results: In CRS group with polyps (42 patients), the most common isolated organisms were Staph. coagulase-negative (26.2%), Staph. areous (23.8%), E-Coli (16.7%), Klebsiella (14.3%) and Enterobacter (7.1%). In CRS group without polyps (52 patients), the most common isolated organisms were Staph. coagulase-negative (25%), Staph. areous (11.5%), Klebsiella (9.6%), E-Coli (7.7%) and Strep. Non-group A (7.7%). Normal flora grew in 5 cultures (9.6%). In only one culture of CRS group without polyp, Pseudomonas was isolated. No resistance was reported from gram-positive bacteria against vancomycin and gram-negative rods were sensitive to ciprofloxacin, ceftriaxon and ceftizoxim.
Conclusion: Despite of some previous studies, the most common micro- organisms in the cultures of CRS cases, regardless of having nasal polyps or not, were Staph. coagulase-negative, Staph. aureus and gram-negative rods, respectively. The incidence of GNRs in CRS group with nasal polyps is higher which may lead to special antibiotic therapy in them. Increasing In Vivo resistance of these bacteria to antibiotics is problematic and the routine old antimicrobial therapy may not be effective enough to control these pathogens and avoid surgical therapy. However, In Vivo evaluations are recommended to reveal a better interpretation.
Key words: Chronic Resistant Rhino Sinusitis-Polyp-Endoscopic Sinus Surgery