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Sinusitis in neurologically impaired children

I Brook1, K Shah

  • 1Department of Pediatrics, Georgetown University, Washington, DC, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|October 22, 1998
PubMed
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Neurologically impaired children with sinusitis often have anaerobic bacteria, including Prevotella and Peptostreptococcus species. These infections frequently involve beta-lactamase-producing bacteria, indicating unique microbiologic features in this population.

Area of Science:

  • Microbiology
  • Pediatric Infectious Diseases
  • Neurology

Background:

  • Sinusitis is common in children, but its microbiology in neurologically impaired (NI) children is less understood.
  • NI children may have unique risk factors and susceptibility to specific pathogens.

Purpose of the Study:

  • To characterize the microbiologic features of sinusitis in NI children.
  • To compare the isolated pathogens with those typically found in non-NI children.

Main Methods:

  • Analysis of sinus aspirates from nine NI children.
  • Bacterial culture and identification of aerobic, facultative, and anaerobic organisms.
  • Detection of beta-lactamase production.

Main Results:

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  • Anaerobic bacteria were found in 67% of aspirates, often mixed with aerobic/facultative bacteria.
  • Predominant anaerobes included Prevotella sp., Peptostreptococcus sp., and Fusobacterium nucleatum.
  • Predominant aerobes included Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus.
  • Beta-lactamase-producing bacteria were isolated in 89% of patients.
  • Similar organisms were found in other sites like tracheostomy and gastrostomy wounds.

Conclusions:

  • Sinusitis in NI children exhibits distinct microbiologic characteristics, with a predominance of facultative and anaerobic gram-negative organisms.
  • These organisms can also colonize other body sites in NI children.
  • Findings highlight the need for tailored diagnostic and therapeutic approaches for sinusitis in this vulnerable population.