Abstract
There is still controversy on which is the best method to collect the secretion directly from the middle meatus or maxillary sinus in patients with chronic rhinosinusitis.Aim: To evaluate the prevalence of bacteria in patients with chronic rhinosinusitis and compare the suction trap collector to direct aspiration attached to a syringe for the microbiological analysis of these secretions.Materials and Methods: Prospective study involving 31 patients who underwent endoscopically guided maxillary secretion aspiration by two different methods (aspiration with the collector tube “suction trap” and aspiration with the use of a catheter connected to a syringe), to determine the microbiological diagnosis and to compare the two methods used.Results: microorganisms grew samples collected from 55% of the 31 patients. The most frequent bacteria were S. aureus, Pseudomonas aeruginosa and other aerobic Gram-negative bacteria. The results from cultures were similar between the two methods in 71% of patients.Conclusion: S. aureus, Pseudomonas aeruginosa and other aerobic Gram-negative bacteria make up the main flora in the maxillary sinus of the patients. There was good correlation between the microbiological results obtained by using a catheter attached to a syringe and the “suction trap” nasal collector.
Highlights
Despite the different studies done with Chronic Rhinosinusitis (CRS), we still do not know clearly the true pathogenic mechanisms and etiological agents participating in this disease
S. aureus, Pseudomonas aeruginosa and other aerobic Gram-negative bacteria make up the main flora in the maxillary sinus of the patients
Comparing the microbiological profile between the two types of collection, we observed the growth of eleven Gram-negative bacteria and four Gram-positive in the syringe group, and Staphylococcus aureus was the most frequent in both groups (26.7% of the positive samples were obtained from the collector and 18.2% of the positive samples were obtained from the syringe)
Summary
Despite the different studies done with Chronic Rhinosinusitis (CRS), we still do not know clearly the true pathogenic mechanisms and etiological agents participating in this disease. Contrary to the findings from microbiology studies carried out in patients with acute rhinosinusitis, there is no definitive and consistent data on the true distribution of bacterial pathogens present in patients with CRS Part of this uncertainty is due to the major variability of the methods used in these studies (different collection methods, prior use of antibiotics, variations in culture methods), besides the difficulties in distinguishing which are the pathogens and which are only colonizing agents. Maxillary sinus punction through the canine tooth fossa was until recently considered the gold standard method to collect samples for microbiological studies in patients with sinusitis It is a painful and invasive procedure, which depends on patient collaboration and sometimes requires local anesthesia, sedation or even general anesthesia[1,2]. Despite the broad acceptance of less invasive techniques, there is no evidence in regards of the equivalence between the different methods used to collect secretions from the middle meatus
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