Bacterial infection in chronic rhinosinusitis: A controlled paired analysis
Bacterial infection in chronic rhinosinusitis: A controlled paired analysis
复制标题
DOI：
10.1177/194589240501900602
复制
发表时间：
2005-11-01
期刊：
影响因子：
--
通讯作者：
Bhattacharyya, N
中科院分区：
文献类型：
--
作者：
Bhattacharyya, N
背景资料：本研究的目的是确定是否致病菌参与慢性鼻窦炎（CRS）的发病机制。方法：一个连续系列的成人患者单侧鼻窦疾病确定单侧影像学参与或单侧脓性分泌物进行了微生物学研究。需氧和厌氧细菌和真菌培养获得在内窥镜鼻窦手术期间从脓分泌物或组织培养。阳性培养率之间进行了比较患病窦和对侧非患病（对照）窦，以确定是否致病菌更常见的回收从患病sinuses.Results：49名成年患者完成了研究，适当的微生物学数据。凝固酶阴性葡萄球菌是最常见的回收细菌，其次是来自鼻窦患病侧的金黄色葡萄球菌，对照鼻窦的结果相似。从鼻窦患病侧的87.8%中回收到细菌种类，而对照鼻窦为85.7%（p = 0.50）。将凝固酶阴性葡萄球菌视为非病原体的再分析显示，患病组和对照组的细菌培养阳性率分别为46.9%和49.0%（p = 0.50）。两组之间的阳性厌氧培养率无显著差异（患病组为59.1%，对照组为55.1%，p = 0.61）。结论：CRS患者的病变鼻窦和非病变鼻窦中均存在需氧菌和厌氧菌，两者的耐药率无显著性差异（p = 0.115）。这些发现对细菌在CRS中的确切病因作用提出了一些疑问，表明其他因素或其他药物也可能在CRS发病机制中起作用。
Background: The aim of this study was to determine if pathogenic bacteria are involved in the pathogenesis of chronic rhinosinusitis (CRS).Methods: A consecutive series of adult patients with unilateral sinus disease determined by unilateral radiographic involvement or unilateral purulent secretions was microbiologically studied. Aerobic and anaerobic bacterial and fungal cultures were obtained during endoscopic sinus surgery from purulent secretions or tissue culture. Positive culture rates were compared between the diseased sinus and the contralateral non-diseased (control) sinus to determine if pathogenic bacteria were more commonly recovered from the diseased sinuses.Results: Forty-nine adult patients completed the study with appropriate microbiological data. Coagulase-negative staphylococci were the most commonly recovered bacteria followed by Staphylococcus aureus from the diseased side of the sinuses with similar findings for the control sinus. Bacterial species were recovered from 87.8% of the diseased side of the sinuses versus 85.7% from the control sinuses (p = 0.50). Reanalysis with coagulase-negative staphylococci considered as nonpathogen showed a 46.9 and 49.0% positive bacterial culture rate in diseased and control groups, respectively (p = 0.50). No significant difference in positive anaerobic culture rates were identified between groups (59.1% diseased versus 55.1% control, respectively, p = 0.61). Antibiotic resistance rates were no different between bacteria cultured from diseased sinuses versus control (p = 0.115).Conclusion: Both aerobic and anaerobic bacterial species may be recovered from both diseased and nondiseased sinuses in patients with CRS. These findings cast some doubt on the exact etiologic role of bacteria in CRS, suggesting other factors or other agents also may be responsible in CRS pathogenesis.