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Related Experiment Videos

Bacterial infection after endoscopic sinus surgery: a controlled prospective study.

Neil Bhattacharyya1, Harsha V Gopal, Kun Hee Lee

  • 1Division of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. neiloy@massmed.org

The Laryngoscope
|April 6, 2004
PubMed
Summary

Post-endoscopic sinus surgery infections are usually new bacterial infections, not overgrowth of existing sinonasal flora. Cultures are essential for guiding antibiotic treatment in chronic rhinosinusitis exacerbations.

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Area of Science:

  • Otolaryngology
  • Microbiology
  • Infectious Diseases

Background:

  • Endoscopic sinus surgery (ESS) is a common procedure for chronic rhinosinusitis (CRS).
  • Postoperative sinonasal infections can occur, raising questions about their origin.
  • Distinguishing between bacterial overgrowth and new infections is crucial for effective management.

Purpose of the Study:

  • To investigate whether postoperative infections after ESS are due to overgrowth of existing sinonasal bacteria or new bacterial infections.
  • To compare baseline sinonasal flora with cultures obtained during infectious exacerbations.

Main Methods:

  • A prospective controlled cohort study followed 113 adult patients post-ESS.
  • Baseline ethmoid sinus cultures were obtained post-surgery.

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  • Cultures from patients experiencing acute infectious exacerbations of CRS were compared to baseline data.

    • Main Results:

    • Postoperative cultures showed colonization in 60% of cases, with Gram-positive cocci being most common.
    • During follow-up, 20 acute exacerbations were cultured.
    • Infectious cultures predominantly yielded bacteria different from baseline flora (75% of isolates).

    Conclusions:

    • Postoperative sinonasal infections following ESS are typically de novo infections, not simple overgrowth of colonized bacteria.
    • Empirical antibiotic therapy based on baseline flora may be ineffective.
    • Cultures are recommended for acute exacerbations of CRS post-ESS to guide appropriate antibiotic selection.