Distribution of Pathogenic Bacteria and Antimicrobial Resistance After Cosmetic Augmentative Rhinoplasty

Cosmetic augmentative rhinoplasty (CAR) can alter undesirable nasal features, increasing people's self-confidence and encouraging social activities.

Pathogens that caused postoperative infection after CAR between January 2012 and December 2021 were retrospectively analyzed, and the trends in each pathogen's detection rate were recorded. The antibiotic sensitivity and distribution characteristics of common pathogens were studied, along with the sites of infection and the rhinoplasty materials used during surgery.

In this study, 123 samples from 115 patients were included, in which 82 gram-positive bacteria were found. Staphylococcus aureus (53/82) and coagulase-negative staphylococci (CoNS) (23/82) ranked the highest of the gram-positive bacteria. The 41 gram-negative bacteria included 10 strains of Enterobacter aerogenes, 6 strains of Klebsiella, 6 strains of Enterobacter cloacae, and 6 strains of Pseudomonas aeruginosa. Methicillin-resistant S. aureus was found in 7 cases (13.2%) and methicillin-resistant CoNS in 15 cases (65.2%). The rhinoplasty materials included silicone, expanded polytetrafluoroethylene, costal cartilage, auricular cartilage, and hyaluronic acid. We found that S. aureus was the major bacterium causing postoperative infection associated with most materials, save for hyaluronic acid and expanded polytetrafluoroethylene. Infection usually occurred at the nasal tip, and the various rhinoplasty materials are associated with diverse types of bacteria.

The primary reason for postoperative infection of CAR is gram-positive bacteria. Knowing the trends of pathogenic bacteria over time, related antibiotic sensitivity, what bacteria are found at different sites, and the bacterial distribution after surgery using different augmentative rhinoplasty materials may help prevent and treat infection following CAR.