Methicillin-resistant Staphylococcus aureus infections in acute rhinosinusitis.
OBJECTIVE
Methicillin-resistant Staphylococcus aureus (MRSA) has recently become a serious problem in various fields of medicine. However, it has rarely been studied in acute rhinosinusitis. The aim of this study was to identify the clinical manifestations and treatment outcome of community-acquired methicillin-resistant S. aureus in acute rhinosinusitis.


METHODS
This was a prospectively collected case series.


METHODS
Since 2000, we have launched a prospective long-term study for bacteriology, drug susceptibility, and their changing trend in acute rhinosinusitis. Patients with the diagnosis of acute rhinosinusitis were enrolled from October 2000 through March 2003. Their middle meatus discharge was taken for aerobic culture. Antibiotic sensitivity test was performed for each isolate.


RESULTS
A total of 601 patients with the diagnosis of acute rhinosinusitis were included in this study. MRSA was isolated in 16 specimens. Its prevalence rate in acute rhinosinusitis was 2.7% (16 of 601). Multiple pathogens were more frequently found in children with MRSA infection. Five of seven adults had previous nasal procedures. Eight of nine children had a history of antibiotic use. Except for two patients without follow up, the remaining 14 patients resolved after receiving oral antibiotics according to culture results.


CONCLUSIONS
The incidence of MRSA infection in acute rhinosinusitis was 2.7% in our study. The most important risk factor was nasal surgeries in adults and previous antibiotic use in children. The treatment outcome of community-acquired MRSA was excellent with oral antibiotics.
Huang
Wei-Hsiung
WH
Department of Otolaryngology, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan. sphenoideus@yahoo.com.tw
Hung
Pei-Kai
PK
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D011446:Prospective Studies; D012220:Rhinitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors; D012852:Sinusitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome