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. 2011 Jan-Feb;77(1):102-6.
doi: 10.1590/S1808-86942011000100017.

[Nosocomial sinusitis in an intensive care unit: a microbiological study]

[Article in Portuguese]
Leonardo Lopes Balsalobre Filho  1 , Fernando Mirage Jardim Vieira, Renato Stefanini, Ricardo Cavalcante, Rodrigo de Paula Santos, Luis Carlos Gregório
Affiliations

[Nosocomial sinusitis in an intensive care unit: a microbiological study]

[Article in Portuguese]
Leonardo Lopes Balsalobre Filho et al. Braz J Otorhinolaryngol. 2011 Jan-Feb.

Abstract

Nosocomial sinusitis is a common complication of patients in ICUs. Its diagnosis is important, and early treatment is required to avoid serious complications such as pneumonia, sepsis, meningitis, and intracranial abscesses.

Aim: To identify the germs causing sinusitis in ICUs by nasal swabs and maxillary sinus puncture, and to correlate these results.

Methods: ICU patients with a diagnosis (CT confirmed) of maxillary sinusitis underwent nasal swab and puncture of the sinus to collect material for culture and antibiogram.

Results: This study evaluated 22 patients. The microbial agent isolated in the swab correlated with the agent in the puncture in 14 of 22 cases (63%). Gram-negative bacteria were the most frequent, as follows: Pseudomonas aeruginosa (29% of punctures), following by Proteus mirabillis (26%) and Acinetobacter baumanni (14%). The resistance index in the antibiogram was high to antibiotics.

Conclusion: Maxillary sinus puncture of ICU patients with sinusitis appears to be the best method for identifying bacteria; antibiograms demonstrate resistance to therapy. The swab has little diagnostic value; the correlation was 63%. It may be used when sinus puncture is contraindicated.

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Figures

Figure 1
Figure 1
Bacteria species isolated from the culture of a secretion obtained from a middle meatus swab.
Figure 2
Figure 2
Bacteria species isolated from the culture of a secretion obtained through antral puncture.
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