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Antimicrobial resistance in bacterial chronic sinusitis

J Hsu¹, D C Lanza, D W Kennedy

¹Department of General Internal Medicine, University of Pennsylvania Health System, Philadelphia 19104, USA.

American Journal of Rhinology

|September 19, 1998

Summary

Emerging antimicrobial resistance in chronic sinusitis is a growing concern. This study found higher resistance rates in common bacteria like Staphylococcus and Pseudomonas, including quinolone-resistant Pseudomonas aeruginosa.

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Area of Science:

Infectious Diseases
Microbiology
Otolaryngology

Background:

Emergence of antimicrobial-resistant bacteria in acute sinusitis.
Increased incidence of enteric gram-negative bacilli in chronic sinusitis.
Need to characterize resistance patterns in outpatient chronic sinusitis.

Purpose of the Study:

To identify emergent resistance patterns in bacterial chronic sinusitis.
To characterize the bacteriology of outpatient chronic sinusitis.
To compare antimicrobial susceptibilities with standard tertiary care center data.

Main Methods:

Cross-sectional study of 113 new outpatients with chronic sinusitis (March-August 1994).
Endoscopically guided aerobic cultures of paranasal sinuses and nasal cavities in 34 patients.

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Analysis of 48 cultures yielding 72 bacterial isolates.

Main Results:

Most frequent isolates: Coagulase-negative Staphylococcus (28%), Pseudomonas aeruginosa (17%), Staphylococcus aureus (13%).
Higher antimicrobial resistance observed in Staphylococcus coagulase-negative, Pseudomonas, and Pneumococcus compared to non-urinary isolates.
50% of Pseudomonas aeruginosa isolates were quinolone-resistant.

Conclusions:

Preliminary data suggest increased antimicrobial resistance in chronic sinusitis.
Potential increase in enteric gram-negative bacilli in this patient population.
Highlights the need for ongoing surveillance of resistance patterns in chronic bacterial sinusitis.