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

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.