engleski

Bacterial colonization or infection in chronic sinusitis.

The purpose of this study was to establish the role of bacteria found in chronicaly inflamed sinuses and to evaluate if the bacteria present colonized or infected sinus mucosa. In this study we made nasopharyngeal and sinus swabs in 65 patients that underwent functional endoscopic sinus surgery with diagnose of chronic sinusitis based on a history of sinusitis lasting for more than 3 months, the findings of nasal endoscopy and CT scans. The nasopharyngeal swabs were taken immidiately before the endoscopis sinus surgery while maxillary and ethmoidal sinus swabs were taken during the operation. The swabs was used for Gram stain smear and then cultivated on both selective and nonselective culture media. At the magnification of X100 the number of leukocytes in smears was scored as significant if >10 laukocytes were present in high power field, or insignificant if <10 leukocytes were present. The most frequently found bacteria in nasopharynx were Staphylococcus aureus, Staphylococcus epidermitis, Streptococcus spp, Streptococcus pneumoniae. The most frequently found bacteria in sinuses were Staphylococcus epidermitis, Staphylococcus aureus, Klebsiella spp and Streptococci (pneumoniae, viridans and spp). The insignificant number of leukocytes was present in each sinus and nasopharyngeal swab. According the most same bacterial colonization founding in nasopharynx and sinuse mucosa in chronic sinusitis patients chronic sinusitis should be considered a chronic inflammatory condition rather than bacterial infection. Routine antibiotic therapy should be avoided. Empiric antibiotic therapy should be prescribed just in case when the acute exacerbation of chronic situsitis ocures.

Chronic sinusitis ; bacterial colonization ; infection

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