Nosocomial sinusitis with isolation of anaerobic bacteria in ICU patients.
OBJECTIVE
To determine the frequency and the eventual clinical characteristics of nosocomial sinusitis with anaerobic bacteria isolation in patients in the intensive care unit (ICU).


METHODS
Retrospective study.


METHODS
A 12-bed medical ICU in a teaching hospital.


METHODS
30 adult patients with documented nosocomial maxillary sinusitis.


METHODS
None.


RESULTS
Using appropriate microbiological techniques, 33 anaerobic bacterial strains were isolated in 18/30 patients (60 %) with nosocomial sinusitis. Anaerobic bacteria were associated with aerobic strains in 13 patients (72 %), whereas in 5 patients (28 %) only anaerobic strains were isolated in sinus puncture cultures. The most frequently isolated species were Prevotella sp. (n = 20, 60 %) and Fusobacterium nucleatum (n = 5, 15 %). The production of beta -lactamase was demonstrated in 13/27 gram-negative anaerobic bacteria. All patients in whom anaerobic bacteria were isolated from transnasal punctures had had a nasogastric tube. Patients in whom anaerobic bacteria were isolated more frequently had neurological disorders upon admission (p < 0.02). Ten patients (30 %) had nosocomial pneumonia, 8 of whom had at least one identical strain in both lung and sinus cultures, including 2 patients with anaerobic bacteria isolation.


CONCLUSIONS
Using appropriate microbiological techniques, anaerobic bacteria were frequently isolated in nosocomial sinusitis. If necessary, the empirical choice of antimicrobial therapy in patients with nosocomial sinusitis should take into account these results.
Le Moal
G
G
Service de Réanimation Médicale, CHU Poitiers, 86021 Poitiers Cedex, France.
Lemerre
D
D
Grollier
G
G
Desmont
C
C
Klossek
J M
JM
Robert
R
R
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001421:Bacteria, Anaerobic; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D001431:Bacteriological Techniques; D001707:Biopsy, Needle / Q000379:methods*; D003422:Critical Care; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018579:Patient Selection; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012852:Sinusitis / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control
D000900:Anti-Bacterial Agents