Comparison of swabs versus suction traps for endoscopically guided sinus cultures

Knowledge of the causative organism(s) in bacterial rhinosinusitis has become the cornerstone of adequate medical and surgical management. Little uniformity and data exist for the best method of obtaining sinus cultures. Most otolaryngologists tend to use the nasal swab for obtaining transnasal middle meatal cultures. A prospective study was carried out to compare the effectiveness of standard nasal swabs versus suction traps in obtaining bacterial isolates under endoscopic guidance.

Fifty-two patients with purulence in the middle meatus or frontal recess were included in the study. All patients were cultured using nasal wire swabs. Twenty-five of these patients also had the purulence suctioned into a Xomed Sinus Secretion Collector (XSSC) (Xomed Surgical Products, Jacksonville, FL), and 27 patients had the purulence suctioned into a standard Leukens trap (Busse Hospital Disposables, Hauppauge, NY). All specimens were sent to the hospital microbiology laboratory within 1 hour of capture.

The average number of bacteria cultured per patient was 1.21 for the swab, 1.37 for the XSSC trap, and 1.08 for the Leukens trap. The agreement between bacteria captured from the wire swab and suction trap was 76.9%, with significant agreement being observed by all isolates with the exception of coagulase-negative Staphylococcus and the other gram-positive bacteria group consisting of Streptococcus viridans, beta-hemolytic streptococcus, and alpha-hemolytic streptococcus.

This study suggests that the wire swab appears to be as efficacious at obtaining endoscopically guided cultures as the Xomed and Leukens suction devices.