Dan Yaniv1,2, Daniel Stern3,4, Igor Vainer5,3, Haim Ben Zvi6, Dafna Yahav3,7, Ethan Soudry5,3. 1. Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tiqva, Israel. dan_yaniv6@yahoo.com. 2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. dan_yaniv6@yahoo.com. 3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Department of Otorhinolaryngology, Head and Neck Surgery, Edith Wolfson Medical Center, Holon, Israel. 5. Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tiqva, Israel. 6. Microbiologic Laboratory, Rabin Medical Center, Petah Tiqva, Israel. 7. Infectious Diseases Unit, Rabin Medical Center, Petah Tiqva, Israel.
Abstract
PURPOSE: The purpose of this study was to describe the microbiology of recurrent acute exacerbations of chronic rhinosinusitis over time. METHODS: Retrospective review of patients with recurrent acute exacerbations of chronic rhinosinusitis who underwent endoscopic-guided cultures during acute exacerbations of chronic rhinosinusitis. RESULTS: 386 cultures were obtained from 112 patients during recurrent acute exacerbations of CRS. A change of bacterial isolates during the course of recurrent exacerbations was observed in 68% (76/112) of patients, necessitating a change of treatment in 40% (45/112). The main risk factor for the subsequent change in cultures was polymicrobial growth. Sinus surgery was not associated with subsequent change in cultured isolates. Resistant strains developed in 11.6% (13/112) of patients, of whom those with abnormal mucociliary clearance being at the highest risk. CONCLUSION: Repeated middle meatal cultures should be considered in patients with recurrent exacerbations of CRS, particularly in cases not responding to standard therapy.
PURPOSE: The purpose of this study was to describe the microbiology of recurrent acute exacerbations of chronic rhinosinusitis over time. METHODS: Retrospective review of patients with recurrent acute exacerbations of chronic rhinosinusitis who underwent endoscopic-guided cultures during acute exacerbations of chronic rhinosinusitis. RESULTS: 386 cultures were obtained from 112 patients during recurrent acute exacerbations of CRS. A change of bacterial isolates during the course of recurrent exacerbations was observed in 68% (76/112) of patients, necessitating a change of treatment in 40% (45/112). The main risk factor for the subsequent change in cultures was polymicrobial growth. Sinus surgery was not associated with subsequent change in cultured isolates. Resistant strains developed in 11.6% (13/112) of patients, of whom those with abnormal mucociliary clearance being at the highest risk. CONCLUSION: Repeated middle meatal cultures should be considered in patients with recurrent exacerbations of CRS, particularly in cases not responding to standard therapy.