Análise microbiológica em secreção de seio maxilar nos pacientes com rinossinusite crônica

Abstract

There isn't definitive and consistent data concerning the distribution of bacterial species in patients with Chronic Sinusitis (CS). The variability of the results from studies in CS may be due to the different techniques used as collection method, variations in culture methods, previous antibiotic use, and difficulty in distinguishing bacterial flora from pathogenic agents. Study design: Clinical prospective. Aim: To identify the incidence of microorganisms in patients with CRS by growing bacteria from the secretion of the maxillary sinus. Patients and Methods: Cross-sectional study in 62 patients that had undergone FESS for treatment of chronic sinusitis; cultures from the maxillary sinus were obtained. Results: 62 samples, 33 (53.2%) had no growth; 29 (45.2%) counts of aerobic bacteria; one case (1.6%) of fungus growth; we did not find anaerobic bacteria. Pseudomonas aeruginosa was the one more frequently found-8 samples (27.6%), Staphylococcus aureus and Staphylococcus epidermidis in 4 samples each; Streptococcus pneumoniae in 3 samples (10.4%); other Gram negative agents in 17 samples (31%). Conclusion: In the present study we concluded that Pseudomonas aeruginosa, other Gram negatives bacteria and Staphylococcus spp were the representatives of the bacterial flora found in the paranasal sinuses of patients with CS.

The pathophysiological role of bacterial biofilms in chronic sinusitis

“…In comparison to the results obtained by other authors, our results are significantly higher. Nigro et al [21] isolated CNS in 12.1 % of patients, whereas Mantovani et al [22, 23] isolated S. epidermidis in 13.9 % of CRS patients. The role of CNS in pathogenesis is still unclear, because coagulase-negative cocci tend to colonize the nasal cavity under normal circumstances and are thought to be a contamination.…”

“…Therefore, this fact refutes their potential as a constitutive factor in the development of chronic sinusitis. CNS plays an important role in the infectious process due to the formation of various intra- and extracellular biochemical compounds, such as lipopolysaccharides, and proteinaceous adhesive substances enable the successful colonization and persistence of infection [21, 22]. A comparison of the microbiological flora of the sinus mucosa between CRS and control patients revealed that S. aureus was more frequently present (11.3 %) in CRS patients.…”

“…However, the same level of S. epidermidis was similar. The increased level of S. aureus in the disease group has important clinical implications [23]. …”

“…Hsu et al [24], Nadel et al [25], and Araujo et al [26] observed gram-negative microbes in 327 (26 %) infected patients, whereas Mantovani et al [23] observed gram-negative microbes in 58.6 % of infected patients. The predominant isolates in these studies were P. aeruginosa and H. influenzae.…”

Bacterial findings in optimised sampling and characterisation of S. aureus in chronic rhinosinusitis

“…The role of bacteria in CRS is less clear, and findings of Staphylococcus aureus , coagulase-negative staphylococci (CoNS), and anaerobes seem to dominate to various extents in different studies [13–19]. However, a Brazilian study of 62 samples from maxillary sinuses of CRS patients found no anaerobes, and Pseudomonas aeruginosa was the most commonly found bacterium [20]. The variability in microbial presence in different studies might be a result of differences in culturing techniques, contamination of samples, patient selection, ethnic origin of the patients, and pre-treatment regimens.…”