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Published on: June 20, 2018
[Microbiological study of persistent rhinosinusitis after endoscopic sinus surgery]
Yanni Li1, Banghua Liu, Weijia Kong
1Department of Otolaryngology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Objective:
To investigate the microbiology of persistent rhinosinusitis after endoscopic sinus surgery (ESS).
Method:
A total of 143 patients with chronic rhinosinusitis (CRS) were selected to performed the endoscopy sinus surgery, cultures of the purulent discharges from ethmoid sinus were obtained during the operation. The patients were then followed for more than 6 months. Cultures were obtained in 49 patients who were not successfully cured 6 months after surgery. Culture results were compared between two groups.
Result:
Of 143 specimens taken during the operation, 153 isolates were detected. Of 49 specimens taken from ethmoids postoperatively, 65 isolates were detected. Between two groups, there was no significant difference in the detection rate of Gram-positive coccus, and there was significant difference in the detection rate of Gram-negative rod and anaerobic bacteria. The detection rate of antibiotic-resistant organisms were significantly higher in postoperative specimens than in preoperative specimens.
Conclusion:
Bacteria infection is one of the etiological factors of persistent rhinosinusitis after ESS. Of the pathogenic bacteria of postoperative rhinosinusitis, Gram-positive coccus are continued to be predominant. Gram-negative rods are comparatively increased. While anaerobes are reduced. Antibiotic resistant organisms are more frequent. To treat the postoperative rhinosinusitis, obtaining a culture of the postoperative sinus cavity may therefore be important.
Insights
Persistent rhinosinusitis after endoscopic sinus surgery (ESS) is often caused by bacterial infections. Postoperative cultures reveal increased Gram-negative rods and antibiotic-resistant organisms, necessitating targeted treatment strategies.
Area of Science:
- Otolaryngology
- Microbiology
- Infectious Diseases
Context:
- Chronic rhinosinusitis (CRS) affects millions globally.
- Endoscopic sinus surgery (ESS) is a common treatment for CRS.
- Persistent or recurrent infections post-ESS pose a clinical challenge.
Purpose:
- To investigate the microbiological differences in persistent rhinosinusitis following ESS.
- To compare bacterial profiles in preoperative and postoperative sinus cultures.
- To identify pathogens contributing to treatment failure after ESS.
Summary:
- 143 patients with CRS undergoing ESS were studied.
- Preoperative and postoperative (if persistent) ethmoid sinus cultures were analyzed.
- Postoperative cultures showed a higher prevalence of Gram-negative rods and antibiotic-resistant organisms compared to preoperative cultures, while anaerobes decreased. Gram-positive cocci remained predominant.
Impact:
- Highlights bacterial infection as a key factor in persistent rhinosinusitis post-ESS.
- Suggests a shift in microbial landscape after surgery, with an increase in Gram-negative rods and resistance.
- Emphasizes the importance of obtaining postoperative sinus cultures for guiding targeted antibiotic therapy in persistent cases.
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