title: Microbiology of the middle meatus compared to sputum in young patients with cystic fibrosis from Bahia - Brazil.
abstract: Lower airway infection is a major cause of morbidity and mortality in patients with cystic fibrosis. It is currently unknown if the infection of the upper airway can cause exacerbation of lower respiratory tract infection. This study aimed to determine the microbiological profile of the anterior paranasal sinuses outflow tract (middle meatus) of cystic fibrosis outpatients. The microbiological profile was defined using endoscopically directed middle meatal cultures. Paired middle meatal and sputum specimens were collected from 56 outpatients for aerobic cultures. A semi-quantitative leukocyte count of the middle meatal samples was performed. The median age of patients was nine years (3-20 years). Staphylococcus aureus (37%), Staphylococcus coagulase-negative (25%), Neisseriac (14%), Pseudomonas aeruginosa (11%), and Streptococcus pneumoniae (7%) were the most prevalent microorganisms in the middle meatal cultures. Using the middle meatal leukocyte count, 16 out of 54 patients (29.6%) presented sinus infection. The most frequently identified pathogens in patients with sinus infections were Staphylococcus aureus (10 patients), Pseudomonas aeruginosa (4 patients), and Streptococcus pneumoniae (3 patients). Agreement of paired middle meatal and sputum cultures was significantly higher among patients with infection in middle meatal (69%). The most common middle meatal pathogens were the typical cystic fibrosis spectrum. This suggests the potential for participating in post-nasal lower airway seeding.
authors.affiliation: Postgraduate Course in Medicine and Human Health of Bahian School of Medicine and Public Health, Salvador, BA, Brazil; Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil. Electronic address: alessandrotunesb@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tunes
authors.affiliation: Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil; Oswaldo Cruz Foundation, Salvador, BA, Brazil. Electronic address: joice@ufba.br.
authors.forename: Joice Neves
authors.initials: JN
authors.lastname: Reis
authors.affiliation: Postgraduate Course in Medicine and Human Health of Bahian School of Medicine and Public Health, Salvador, BA, Brazil; Pediatric Pulmonary Clinic of Bahia Reference Center for Cystic Fibrosis, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: reginaterse@gmail.com.
authors.forename: Regina
authors.initials: R
authors.lastname: Terse
authors.affiliation: Pediatric Pulmonary Clinic of Bahia Reference Center for Cystic Fibrosis, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: angelicasantana@terra.com.br.
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: Santana
authors.affiliation: Pediatric Pulmonary Clinic of Bahia Reference Center for Cystic Fibrosis, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: heom@saude.ba.gov.br.
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Diniz
authors.affiliation: Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil. Electronic address: tfbarros@uol.com.br.
authors.forename: Tânia Fraga
authors.initials: TF
authors.lastname: Barros
authors.affiliation: Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil. Electronic address: aksleal@gmail.com.
authors.forename: Ana Karina Souza
authors.initials: AK
authors.lastname: Leal
authors.affiliation: Microbiological Laboratory, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: heom@saude.ba.gov.br.
authors.forename: Vilma
authors.initials: V
authors.lastname: Paixão
authors.affiliation: Postgraduate Course in Medicine and Human Health of Bahian School of Medicine and Public Health, Salvador, BA, Brazil; Oswaldo Cruz Foundation, Salvador, BA, Brazil. Electronic address: grassi@bahia.fiocruz.br.
authors.forename: Maria Fernanda Rios
authors.initials: MF
authors.lastname: Grassi
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000382:microbiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D010256:Paranasal Sinuses / Q000382:microbiology*; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology*; D055815:Young Adult
keywords: Cystic fibrosis; Endoscopy; Infection; Middle meatus