Bacteriological findings and antimicrobial resistance in odontogenic and non-odontogenic chronic maxillary sinusitis

Abstract

The main objectives of this study were to estimate the frequency of chronic maxillary sinusitis of dental origin, and to evaluate the microbiology of odontogenic and non-odontogenic chronic maxillary sinusitis. Aspirates from 59 patients with chronic maxillary sinusitis (47 non-odontogenic, 12 odontogenic), collected during a 3-year period, were microbiologically processed for aerobic and anaerobic bacteria. Moreover, antimicrobial susceptibility was evaluated in the isolated bacteria. In this study, 20 % of chronic maxillary sinusitis cases were associated with a dental origin, and sinus lift procedures were the main aetiological factor. Our microbiological findings showed that all specimens from chronic maxillary sinusitis were polymicrobial. Sixty aerobes and 75 anaerobes were recovered from the 47 cases of non-odontogenic sinusitis (2.9 bacteria per specimen); 15 aerobes and 25 anaerobes were isolated from the 12 patients with odontogenic sinusitis (3.3 bacteria per specimen). The predominant aerobes were Staphylococcus aureus (27) and Streptococcus pneumoniae (16), while the more frequent anaerobes were Peptostreptococcus species (31) and Prevotella species (30). Haemophilus influenzae and Moraxella catarrhalis were absent in sinusitis associated with a dental origin. Overall, 22 % of Staphylococcus aureus isolates were oxacillin-resistant, and 75 % of Streptococcus pneumoniae isolates were penicillin-resistant and/or erythromycin-resistant; 21 % of anaerobic Gram-positive bacteria were penicillin-resistant, and 44 % of anaerobic Gram-negative bacteria were blactamase-positive. Vancomycin and quinopristin-dalfopristin had the highest in vitro activity against Staphylococcus aureus and Streptococcus species, respectively; amoxicillin-clavulanate and cefotaxime showed the highest in vitro activity against aerobic Gram-negative bacteria; and moxifloxacin, metronidazole and clindamycin were the most active against anaerobic bacteria.

Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis

“…44 Recently, evidence of cytokine and chemokine mRNA expression in canine sino-nasal aspergillosis and idiopathic LPR has determined that these two conditions have different and distinct pathophysiology and low grade occult fungal disease is not likely the cause for LPR. 20 A sinusitis study identified predominate anaerobic isolates in 71% of periapical infections as well as anaerobic isolates in 76% and 79% of acute and chronic sinusitis cases, respectively. 45,46 Based on cytokine and mRNA, other fungal organisms suspected (Alternaria and Cladosporium species) are likely not involved.…”

“…In published case series reports and retrospective studies, the differential diagnosis list often does not include dental/oral pathology, whereas in a few studies "periodontal disease" or "tooth abscess" are listed in the discussion and introductions but they do not explore the significance of these pathologies any further. 11,13,14,[18][19][20][21][22][23] Respiratory mucosal pathology occurs secondary to periodontal and endodontic infections. Similar challenges exist in human odontogenic maxillary sinusitis (OMS).…”

Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment

“…We found that half of OS have maxillary and anterior ethmoid sinusitis. In these cases, the anterior ethmoiditis is probably the result of proximity of the maxillary sinus ostium and those of anterior ethmoid sinuses, which facilitate ethmoid inflammation from an infected maxillary sinus (20). Presumably, another crucial factor is related to the time factor, being that the longer evolutionary presents a maxillary sinusitis, more likely is that inflammation spreading to anterior ethmoid sinus causing an anterior ethmoid sinusitis.…”

Maxillary Sinusitis After Sinus Lift Due to Gemella morbillorum

“…13 Information on the antimicrobial susceptibility of these species is limited. 2,14 Infections caused by G. morbillorum have been cured by antibiotic therapy, usually using a combination of penicillin and aminoglycoside. In the penicillinresistant or penicillin-allergic patient, monotherapy or a combination of other antibiotics, such as vancomycin or erythromycin plus rifampicin, have been effective.…”