Bacteriology of the maxillary sinuses in patients with cystic fibrosis

The maxillary sinuses of 20 patients (median age, 15 years) with cystic fibrosis were examined with ultrasound, radiography, and transantral sinus aspiration (14 bilateral and six unilateral for a total of 34 aspirates). The sinus aspirations were performed with careful sterile techniques, and the material that was recovered was cultured quantitatively for both aerobic and anaerobic bacteria. Nineteen (95%) of the 20 patients had at least one positive (greater than or equal to 10(4) colony-forming units/ml) culture of sinus aspirate. The organisms most commonly recovered from the sinus aspirates were Pseudomonas aeruginosa (13), Haemophilus influenzae (10), streptococci (five), and anaerobes (five). There was no association between the bacterial species recovered from the sinus and the predominant bacterial species in the nasopharyngeal, throat, or sputum culture. Although most patients had been chronically receiving therapeutic oral doses of antimicrobial agents, bacteria sensitive to the antimicrobial agents that the patient had been taking (excluding P. aeruginosa) were recovered from the sinuses of nine of these 10 patients.