Bacteriological findings and antimicrobial resistance in odontogenic and non-odontogenic chronic maxillary sinusitis
Bacteriological findings and antimicrobial resistance in odontogenic and non-odontogenic chronic maxillary sinusitis
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DOI：
10.1099/jmm.0.031476-0
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发表时间：
2011-09-01
影响因子：
3
通讯作者：
Speciale, Annamaria
中科院分区：
文献类型：
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作者：
Puglisi, Salvatore;Privitera, Salvatore;Speciale, Annamaria
本研究的主要目的是估计牙齿源性慢性上颌窦炎的发生率，并评估牙源性和非牙源性慢性上颌窦炎的微生物学。从59例慢性上颌窦炎患者（47非牙源性，12牙源性），在3年期间收集的吸出物，进行微生物学处理的好氧菌和厌氧菌。此外，抗菌药物的敏感性进行了评价，在分离的细菌。在这项研究中，20%的慢性上颌窦炎病例与牙源性有关，鼻窦提升术是主要的病因。我们的微生物学研究结果表明，所有标本从慢性上颌窦炎是多种微生物。从47例非牙源性鼻窦炎中分离出60株需氧菌和75株厌氧菌（每个标本2.9株细菌）;从12例牙源性鼻窦炎中分离出15株需氧菌和25株厌氧菌（每个标本3.3株细菌）。主要需氧菌为金黄色葡萄球菌（27）和肺炎链球菌（16），而更常见的厌氧菌为消化链球菌属（31）和普雷沃菌属（30）。在与牙源性相关的鼻窦炎中不存在流感嗜血杆菌和卡他莫拉菌。总体而言，22%的金黄色葡萄球菌分离株对苯唑西林耐药，75%的肺炎链球菌分离株对青霉素耐药和/或对红霉素耐药; 21%的厌氧革兰氏阳性菌对青霉素耐药，44%的厌氧革兰氏阴性菌β-内酰胺酶阳性。万古霉素和喹诺菌素-达福普汀分别对金黄色葡萄球菌和链球菌的体外活性最高;阿莫西林-克拉维酸和头孢噻肟对需氧革兰氏阴性菌的体外活性最高;而氟沙星、甲硝唑和克林霉素对厌氧菌的活性最高。
The main objectives of this study were to estimate the frequency of chronic maxillary sinusitis of dental origin, and to evaluate the microbiology of odontogenic and non-odontogenic chronic maxillary sinusitis. Aspirates from 59 patients with chronic maxillary sinusitis (47 non-odontogenic, 12 odontogenic), collected during a 3-year period, were microbiologically processed for aerobic and anaerobic bacteria. Moreover, antimicrobial susceptibility was evaluated in the isolated bacteria. In this study, 20% of chronic maxillary sinusitis cases were associated with a dental origin, and sinus lift procedures were the main aetiological factor. Our microbiological findings showed that all specimens from chronic maxillary sinusitis were polymicrobial. Sixty aerobes and 75 anaerobes were recovered from the 47 cases of non-odontogenic sinusitis (2.9 bacteria per specimen); 15 aerobes and 25 anaerobes were isolated from the 12 patients with odontogenic sinusitis (3.3 bacteria per specimen). The predominant aerobes were Staphylococcus aureus (27) and Streptococcus pneumoniae (16), while the more frequent anaerobes were Peptostreptococcus species (31) and Prevotella species (30). Haemophilus influenzae and Moraxella catarrhalis were absent in sinusitis associated with a dental origin. Overall, 22% of Staphylococcus aureus isolates were oxacillin-resistant, and 75% of Streptococcus pneumoniae isolates were penicillin-resistant and/or erythromycin-resistant; 21% of anaerobic Gram-positive bacteria were penicillin-resistant, and 44% of anaerobic Gram-negative bacteria were beta-lactamase-positive. Vancomycin and quinopristin-dalfopristin had the highest in vitro activity against Staphylococcus aureus and Streptococcus species, respectively; amoxicillin-clavulanate and cefotaxime showed the highest in vitro activity against aerobic Gram-negative bacteria; and moxifloxacin, metronidazole and clindamycin were the most active against anaerobic bacteria.