Middle meatus bacteriology of acute rhinosinusitis in patients after irradiation of nasopharynx.
BACKGROUND
Patients who undergo radiotherapy for nasopharyngeal carcinoma (NPC) tend to suffer from rhinosinusitis because irradiation causes damage to sinonasal tissue; however, their bacteriology is lacking in the literature. The aim of this study was to determine the bacteriology and antibiotic resistance in acute rhinosinusitis (ARS) of these patients.


METHODS
We collected nasal purulent discharge for bacteriology and antibiotic susceptibility tests in irradiated NPC patients with ARS. Middle meatus discharge was aspirated for culture with endoscopic assistance.


RESULTS
A total of 33 episodes of ARS were documented in 25 patients. Staphylococcus aureus comprised 42% of all aerobes. Thirty-six percents of aerobic isolates were Gram-negative bacilli. Peptostreptococcus micros and Veillonella spp were the most frequently isolated anaerobes.


CONCLUSIONS
The bacteriology in irradiated NPC patients with ARS was distinctive in the following: first, the most common pathogen was S. aureus; second, frequently isolated Gram-negative bacilli and anaerobes; and third, polymicrobial infections. The beta-lactamase-producing pathogens were highly prevalent.
Huang
Wei-Hsiung
WH
Department of Otolaryngology, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan. sphenoideus@yahoo.com.tw
Liu
Chia-Ming
CM
Chao
Ting-kuang
TK
Hung
Pei-Kai
PK
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001420:Bacteria, Aerobic / Q000145:classification / Q000187:drug effects; D001421:Bacteria, Anaerobic / Q000145:classification / Q000187:drug effects; D001424:Bacterial Infections / Q000145:classification / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D012220:Rhinitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012852:Sinusitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents