Bacterial Profile and Antibiotic Sensitivity in Patients with Chronic Rhinosinusitis undergoing Functional Endoscopic Sinus Surgery: A Prospective Study

Abstract

Background: Chronic rhinosinusitis (CRS) is a prevalent disorder affecting up to 2% of the world population with a significant impact on the quality of life. Not only is it common, it is also the type of nasal disease with greater propensity for morbidity. The study was done to identify bacteria causing CRS and to obtain information regarding the antibiotic sensitivity of the organism. Materials and methods:A prospective study was done on 109 patients with CRS, undergoing endoscopic sinus surgery. Swabs were obtained from the maxillary sinuses and sent for bacterial cultures and sensitivity tests.Results: Hundred patients (91.7%) were positive for pathogenic organisms. Among them, Gram-positive cocci were seen in 77%, methicillin-sensitive Staphylococcus aureus was found in 49 patients and was the most common organism isolated. This was followed by methicillin-resistant S. aureus (MRSA) in 15 patients and coagulase-negative Staphylococcus (CoNS) in 13 patients. These organisms were most sensitive to Linezolid (96.1%) and least sensitive to Ampicillin and Clindamycin (54.4%). Gram-negative bacilli included Pseudomonas in 11 patients, Klebsiella in 5 patients, and Proteus, Enterobacter, and Fusobacterium one in each patient (3 patients). All the Gramnegative organisms were sensitive to Piperacillin-Tazobactam (100%) and showed 86.9% sensitivity to Amikacin, Imipenem, and Ceftazidime. Conclusion:Our study showed there is rise in the number of methicillin-sensitive S. aureus (MSSA) cases compared to other studies. All organisms isolated in our study showed resistance to majority of the oral and parenteral antibiotics. We also observed an increase in the number of Gram-negative rods, mainly Pseudomonas aeruginosa, and Klebsiella spp., and hence, antibiotic prescription should be streamlined to minimize the chances of rising trend in antibiotic resistance.