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[Nosocomial sinusitis in an intensive care unit: a microbiological study]

Leonardo Lopes Balsalobre Filho1, Fernando Mirage Jardim Vieira, Renato Stefanini

  • 1Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo, São Paulo.

Brazilian Journal of Otorhinolaryngology
|February 23, 2011
PubMed
Abstract

Insights

Maxillary sinus puncture is the best method for identifying bacteria causing sinusitis in intensive care units (ICUs). Nasal swabs have limited diagnostic value, showing only 63% correlation with puncture results.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Context:

  • Nosocomial sinusitis is a frequent complication in intensive care unit (ICU) patients.
  • Accurate diagnosis and prompt treatment are crucial to prevent severe outcomes like pneumonia, sepsis, and meningitis.

Purpose:

  • To identify the causative microorganisms of sinusitis in ICU patients using nasal swabs and maxillary sinus puncture.
  • To compare the diagnostic accuracy of nasal swabs versus maxillary sinus puncture for sinusitis in ICUs.

Summary:

  • A study involving 22 ICU patients with CT-confirmed maxillary sinusitis compared microbial identification from nasal swabs and maxillary sinus punctures.
  • Maxillary sinus puncture yielded a higher diagnostic yield, with Gram-negative bacteria (Pseudomonas aeruginosa, Proteus mirabillis, Acinetobacter baumanni) being most prevalent.
  • Antibiotic resistance was notably high, as indicated by antibiogram results.

Impact:

  • Maxillary sinus puncture is recommended as the primary diagnostic method for ICU-acquired sinusitis due to its superior accuracy.
  • Nasal swabs demonstrated limited utility, correlating with puncture results in only 63% of cases, but may be considered when puncture is contraindicated.
  • Findings highlight the significant challenge of antibiotic resistance in ICU-associated sinusitis.

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