Alberto Maria Saibene1, Christian Vassena2, Carlotta Pipolo1, Mariele Trimboli1, Elena De Vecchi2, Giovanni Felisati1, Lorenzo Drago2,3. 1. Department of Otolaryngology-Head and Neck, San Paolo Hospital, University of Milan, Milan, Italy. 2. Laboratory of Clinical Chemistry and Microbiology, National Institute for Research and Treatment (IRCCS) Galeazzi Orthopaedic Institute, Milan, Italy. 3. Laboratory of Technical Science for Laboratory Medicine, Department of Biomedical Science for Health, University of Milan, Milan, Italy.
Abstract
BACKGROUND: Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) play a relevant, often underappreciated role in paranasal sinus infections. Treating SCDDT patients requires tailored medical and surgical approaches in order to achieve acceptable success rates. These approaches differ from common rhinogenic sinusitis treatment protocols mostly because of the different etiopathogenesis. Our study comprehensively evaluated microbiology and antibiotic resistance in SCDDT patients and compared findings with a control group of patients affected by rhinogenic sinusitis. METHODS: We performed microbiological sampling during surgery on 28 patients with SCDDT and 16 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Colonies were isolated, Gram-stained, and the species identified using classic biochemical methods. These results were confirmed by DNA pyrosequencing, and then the resistance profile of each SCDDT isolate to various antibiotics was tested. RESULTS: Microbial growth was observed in all SCDDT patients, whereas samples from 60% of patients in the control group failed to yield any bacterial growth (p < 0.001). Anaerobes grew in 14% of SCDDT patients as compared to 7% of CRSwNP patients (p = 0.42). Of the isolates from SCDDT patients, 70% were susceptible to amoxicillin/clavulanate, whereas all isolates were susceptible to levofloxacin, teicoplanin, and vancomycin. Of the staphylococci identified, 80% were capable of producing beta-lactamase. CONCLUSION: Given the extent of microbiological contamination within the maxillary sinus of SCDDT patients, these infections should be regarded as a different class of conditions from rhinogenic sinusitis. Our findings support the need for different approaches in the treatment of SCDDT patients.
BACKGROUND: Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) play a relevant, often underappreciated role in paranasal sinus infections. Treating SCDDT patients requires tailored medical and surgical approaches in order to achieve acceptable success rates. These approaches differ from common rhinogenic sinusitis treatment protocols mostly because of the different etiopathogenesis. Our study comprehensively evaluated microbiology and antibiotic resistance in SCDDT patients and compared findings with a control group of patients affected by rhinogenic sinusitis. METHODS: We performed microbiological sampling during surgery on 28 patients with SCDDT and 16 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Colonies were isolated, Gram-stained, and the species identified using classic biochemical methods. These results were confirmed by DNA pyrosequencing, and then the resistance profile of each SCDDT isolate to various antibiotics was tested. RESULTS: Microbial growth was observed in all SCDDT patients, whereas samples from 60% of patients in the control group failed to yield any bacterial growth (p < 0.001). Anaerobes grew in 14% of SCDDT patients as compared to 7% of CRSwNP patients (p = 0.42). Of the isolates from SCDDT patients, 70% were susceptible to amoxicillin/clavulanate, whereas all isolates were susceptible to levofloxacin, teicoplanin, and vancomycin. Of the staphylococci identified, 80% were capable of producing beta-lactamase. CONCLUSION: Given the extent of microbiological contamination within the maxillary sinus of SCDDT patients, these infections should be regarded as a different class of conditions from rhinogenic sinusitis. Our findings support the need for different approaches in the treatment of SCDDT patients.
Authors: Massimo Galli; Giulia De Soccio; Fabrizio Cialente; Francesca Candelori; Francesca Romana Federici; Massimo Ralli; Marco De Vincentiis; Antonio Minni Journal: Bosn J Basic Med Sci Date: 2020-11-02 Impact factor: 3.363
Authors: Antonio M Bulfamante; Carlotta Pipolo; Umberto D'Agostino Fiorenza; Flavio Arnone; Paolo Lozza; Giovanni Felisati; Alberto Maria Saibene Journal: Clin Case Rep Date: 2020-12-14
Authors: Ionuț Isaia Jeican; Lucian Barbu Tudoran; Adrian Florea; Mirela Flonta; Veronica Trombitas; Anda Apostol; Mihai Dumitru; Maria Aluaș; Lia Monica Junie; Silviu Albu Journal: J Clin Med Date: 2020-12-08 Impact factor: 4.241
Authors: Alberto Maria Saibene; Fabio Collurà; Carlotta Pipolo; Antonio Mario Bulfamante; Paolo Lozza; Alberto Maccari; Flavio Arnone; Filippo Ghelma; Fabiana Allevi; Federico Biglioli; Matteo Chiapasco; Sara Maria Portaleone; Alberto Scotti; Roberto Borloni; Giovanni Felisati Journal: Eur Arch Otorhinolaryngol Date: 2018-11-27 Impact factor: 2.503