Microbiological and Molecular Study of Paranasal Sinus Infections of Children with Malignancy and Unknown Origin Fever in Markazi Province, Iran

Abstract

BackgroundChildren with malignancies are vulnerable to various infections, including sinus infections. Sinusitis is primarily caused by bacterial infections, followed by fungal infections. Due to this issue, evaluating the occurrence, diversity, and antibiotic susceptibility patterns of bacterial species that cause paranasal sinus infections in children with malignancy and unexplained fever is important. ObjectiveInvestigate the bacterial species accountable for sinusitis in children with malignancy and unexplained fever, and determine their susceptibility to antibiotics. MethodsThe study involved collecting 90 sinus samples from children aged 5-15 years with malignancy in Arak city. The isolates were identified using a combination of phenotypic, biochemical, and molecular techniques, including specific PCR and 16S rRNA gene sequencing. drug susceptibility testing was performed following the CLSI 2021 guidelines. ResultsA total of 36 isolates (40%) were obtained, including 4 isolates of Nocardia (11.12%), 4 isolates of E. coli (11.12%), 3 isolates of K. pneumoniae (8.33%), 5 isolates of P. aeruginosa (13.88%), 3 isolates of A. baumannii (8.33%), 4 isolates of S. aureus (11.12%), 3 isolates of S. epidermidis (8.33%), 5 isolates of S. agalactiae (13.88%), 2 isolates of S. pneumoniae (5.55%), and 3 isolates of E. faecium (8.33%). The isolates showed the most sensitivity to imipenem and trimethoprim-sulfamethoxazole and the least sensitivity to erythromycin and tetracycline. ConclusionsThe findings of the study indicate that sinusitis can contribute to fever of unknown origin in cancer patients. Therefore, it is recommended to use a combination of molecular and phenotypic methods for accurate identification of isolates. This approach can provide more reliable and precise results, leading to better diagnosis and treatment of sinusitis infections in children with malignancy.