title: Endoscopically-derived bacterial cultures in chronic rhinosinusitis: A systematic review.
abstract: BACKGROUND
  Culture-directed antibiotic therapy represents an important component in the management paradigm of chronic rhinosinusitis (CRS). The objective of this study was to systematically review the literature to assess culture yield of the most common aerobic and anaerobic pathogens.
  
  
  METHODS
  A total of 43 studies between 1975 and 2010 were included.
  
  
  RESULTS
  The composite data comprised 3528 patients with 6005 total culture specimens. The cultures were obtained in operating room in 33 (76.7%) and clinic in 10 (23.3%) of the studies, respectively. The most common site of culture was the maxillary sinus in 18 (41.9%) of the studies. The most common assay techniques reported were swab in 19 (44.2%) and aspirate in 12 (27.9%) studies. The most common gram positive aerobes reported were coagulase negative Staphylococcus and Staphylococcus aureus in 630 (34.7%) and 481 (26.5%) of the cultures, respectively. The most common gram negative aerobes included Haemophilus influenzae and Pseudomonas aeruginosa in 245 (27.0%) and 198 (21.6%) cultures, respectively. The most common anaerobes reported were Peptostreptococcus species in 156 (19.6%) and Bacteroides species in 153 (19.2%) cultures.
  
  
  CONCLUSIONS
  This study provides a composite snapshot of the literature accrued on the microbiology of CRS. It should serve to apprise clinicians on the most common aerobic and anaerobic organisms in CRS patients when employing culture-directed antimicrobial therapy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis Navamindradhiraj, Bangkok, Thailand.
authors.forename: Thunchai
authors.initials: T
authors.lastname: Thanasumpun
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois. Electronic address: pete_batra@rush.edu.
authors.forename: Pete S
authors.initials: PS
authors.lastname: Batra
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification; D012220:Rhinitis / Q000188:drug therapy* / Q000382:microbiology; D012852:Sinusitis / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000890:Anti-Infective Agents