Microbial aetiology of acute rhinosinusitis during pregnancy

Pregnancy as an immunosuppressive condition and with the associated tendency for mucosal oedema can predis- pose women to acute rhinosinusitis. Our hypothesis was that pregnancy enhances opportunistic sinus infections.

We retrospectively collected data on pregnant women with acute rhinosinusitis treated at the Department of Otorhinolaryngology, Helsinki University Hospital, Finland in 2010-2015. Maxillary puncture was performed on all patients, and patients with purulent sinus secretions and bacterial culture were included in the study. Clinical data on patients and microbial findings of bacterial cultures were recorded and compared with those of non-pregnant controls.

Ninety-five pregnant patients and 91 controls were included. The bacterial cultures of pregnant patients revealed bac- terial growth more often than control patients’ specimens (78.9% vs. 54.9%). The most common bacterial findings (pregnant vs. control patients) were Streptococcus pneumoniae 43.2% vs. 20.9%, Haemophilus influenzae 22.1% vs. 16.5%, and Moraxella catar- rhalis 10.5% vs. 2.2%. S. pneumoniae was the most frequent finding in all trimesters, and the proportion of S. pneumoniae sinusitis was highest during the last trimester of pregnancy.

The pathogens of acute rhinosinusitis in pregnant patients are the same as in non-pregnant patients, however, the proportions differ; during pregnancy S. pneumoniae infection is more frequent.