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Published on: December 31, 2017
Microbiology of Acute Maxillary Sinusitis in Children
Shoichi Sawada1, Shigenori Matsubara2
1Department of Otolaryngology, Sawada Eye and Ear Clinic, Fukuicho, Kochi City, Kochi, Japan.
Insights
Pediatric acute sinusitis often involves both bacteria and viruses, with Haemophilus influenzae and Streptococcus pneumoniae being common. Polymerase chain reaction (PCR) is effective for identifying these pathogens in children.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Respiratory medicine
Background:
- Acute rhinosinusitis is a common complication of the common cold in children.
- The precise microbial causes of pediatric acute rhinosinusitis are not well understood.
- Accurate diagnosis is crucial for effective treatment.
Purpose of the Study:
- To investigate the specific microbiology of acute rhinosinusitis in pediatric patients.
- To identify common viral and bacterial pathogens involved.
- To evaluate the utility of PCR in diagnosing pediatric sinusitis.
Main Methods:
- A prospective study involving 31 children (aged 5-14) with severe acute maxillary sinusitis.
- Maxillary sinus aspirates were collected for bacterial culturing and viral/bacterial polymerase chain reaction (PCR) analysis.
- PCR kits were used to detect 18 respiratory viruses and 13 bacteria.
Main Results:
- Pathogens were detected in 97% of aspirates via PCR.
- Viruses and bacteria co-occurred in 32% of cases.
- Common viruses included rhinovirus (13%) and influenza (10%).
- Common bacteria identified by PCR were Haemophilus influenzae (45%), Streptococcus pneumoniae (32%), Moraxella catarrhalis (16%), and Chlamydophila pneumoniae (13%).
- Bacterial culturing identified H. influenzae in 42% of positive cases.
Conclusions:
- Respiratory bacteria were found in 65% of pediatric acute maxillary sinusitis cases, with viral co-infection in 32%.
- Rhinovirus, influenza virus, H. influenzae, and S. pneumoniae are key pathogens.
- Viral and bacterial PCR provides accurate microbiological insights for pediatric sinusitis.
Objectives/Hypothesis:
Acute rhinosinusitis is a frequent common cold-related complication in children. Despite the need for appropriate treatment, its underlying microbiology remains unclear. This study aimed to investigate the microbiology of acute rhinosinusitis in children.
Study Design:
Prospective non controlled study.
Methods:
Thirty-one pediatric acute maxillary sinusitis patients with severe symptoms were assessed. The subjects were 17 males and 14 females aged 5 to 14 years (mean age, 9.1 years). Maxillary sinus aspirates were collected and cultured, with subsequent viral and bacterial polymerase chain reaction (PCR) analysis. Bacteria were analyzed using culturing and PCR, and viruses were analyzed using PCR. The PCR kits used identify 18 types of respiratory viruses and 13 types of bacteria.
Results:
At least one pathogen was detected in 30 of 31 aspirates (97%) using PCR, and none of the aspirates contained respiratory viruses alone. Ten aspirates (32%) contained both viruses and bacteria. The most common viruses detected were rhinovirus (13%) and influenza virus (10%). The most common bacteria were Haemophilus influenzae (45%), Streptococcus pneumoniae (32%), Moraxella catarrhalis (16%), and Chlamydophila pneumoniae (13%). Bacteria were found in 21 of 31 cases (68%) via bacterial culturing. Culturing revealed that H influenzae was the most common pathogen (42%).
Conclusions:
In pediatric acute maxillary sinusitis, respiratory bacteria were detected in 65% of the sinus aspirates and both bacteria and viruses in 32%. The most common viruses were rhinovirus and influenza virus, and the most common bacteria were H influenzae and S pneumoniae. Viral and bacterial PCR is useful for accurately investigating the microbiology in pediatric sinusitis.
Level Of Evidence:
3 Laryngoscope, 131:E2705-E2711, 2021.
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