Todd T Kingdom1, Ron E Swain. 1. Department of Otolaryngology, University of Colorado Health Science Center, Denver, CO 80262, USA. todd.kindom@uchsc.edu
Abstract
OBJECTIVES: The purpose of this study was to review the microbiology of chronic rhinosinusitis (CRS) in patients undergoing endoscopic sinus surgery (ESS) and comment on antimicrobial resistance trends. METHODS: A retrospective review of 101 patients undergoing ESS during the period of 1997 to 2001 was performed. Patients were divided into groups based on their surgical history. Fifty-five patients without prior ESS history were placed in the primary group; 46 patients who had undergone prior ESS were placed in the revision group. Intraoperative microbiology culture data were reviewed and antimicrobial resistance data analyzed. RESULTS: Data on 101 patients were analyzed. There were 182 total cultures sent, yielding 257 isolates. The most common isolates were coagulase-negative Staphylococcus (SCN) (45% of cultures), gram-negative rods (25% of cultures), and Staphylococcus aureus (24% of cultures). Pseudomonas aeruginosa was isolated in 9% of cultures. When comparing the 2 patient groups, we did not find consistent trends in the differences in the prevalence of these isolates. Antimicrobial resistance for SCN (P = .01) and S aureus (P < .001) was greater in the revision surgery. Overall, 62% of patients were found to have at least 1 isolate with decreased antibiotic sensitivity. CONCLUSION: The most prevalent microorganisms in patients with CRS are SCN, S aureus, and gram-negative rods. Perhaps more importantly, the antimicrobial sensitivities of these microorganisms appear to be a growing problem. These findings suggest increased antimicrobial resistance in patients undergoing revision ESS when compared with patients undergoing surgery for the first time.
OBJECTIVES: The purpose of this study was to review the microbiology of chronic rhinosinusitis (CRS) in patients undergoing endoscopic sinus surgery (ESS) and comment on antimicrobial resistance trends. METHODS: A retrospective review of 101 patients undergoing ESS during the period of 1997 to 2001 was performed. Patients were divided into groups based on their surgical history. Fifty-five patients without prior ESS history were placed in the primary group; 46 patients who had undergone prior ESS were placed in the revision group. Intraoperative microbiology culture data were reviewed and antimicrobial resistance data analyzed. RESULTS: Data on 101 patients were analyzed. There were 182 total cultures sent, yielding 257 isolates. The most common isolates were coagulase-negative Staphylococcus (SCN) (45% of cultures), gram-negative rods (25% of cultures), and Staphylococcus aureus (24% of cultures). Pseudomonas aeruginosa was isolated in 9% of cultures. When comparing the 2 patient groups, we did not find consistent trends in the differences in the prevalence of these isolates. Antimicrobial resistance for SCN (P = .01) and S aureus (P < .001) was greater in the revision surgery. Overall, 62% of patients were found to have at least 1 isolate with decreased antibiotic sensitivity. CONCLUSION: The most prevalent microorganisms in patients with CRS are SCN, S aureus, and gram-negative rods. Perhaps more importantly, the antimicrobial sensitivities of these microorganisms appear to be a growing problem. These findings suggest increased antimicrobial resistance in patients undergoing revision ESS when compared with patients undergoing surgery for the first time.
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