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Allergology Review

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  Authority of Polish Society of Allergology

vol 5. no 1. March 2000  

 Original articles
Bacteriology of chronic sinusitis exacerbation. Comparison of different sampling methods
Mariola Śliwińska-Kowalska, Marta Michalska, Izabela Szczerba, Beata Zarzyckaelżbieta Gorzkiewicz, Zbigniew Krzemiński, Marek L. Kowalski

The identification of bacterial strain is crucial for the effective chronic sinusitis treatment. It has been shown, however, that bacteriological assay results strongly depend on the method of sample collection. The aim of the study was to assess the bacteriological strains in patients with chronic sinusitis with four different methods of samples collection, with or without transport culture medium. Twelve subjects with purulent exacerbation of the disease were included into the study. The data were compared with bacteriological findings obtained from 13 patients with non-infectious rhinitis and 5 healthy subjects. The samples were collected as a 1. smear from the middle nasal meatus with a transport medium, 2. nasal washes with a transport medium and 3. maxillary sinus washes with a transport medium, and as a 4. smear from the anterior part of the nose without a transport medium (routine sample collection in the outpatient clinics). The time between the sample collection and inoculation in culture was no longer than 60 min in the first three methods (with a transport medium). It was unknown in case of the routine method.
The results indicate that the main pathogenic bacterial strains in the purulent chronic sinusitis are Klebsiella pneumoniae (ssp. pneumoniae and ssp. ozenae), Haemophilus influenzae and parainfluenzae, Streptococcus pneumoniae and Pseudomonas aeruginosa. The colonisation with Staphylococcus aureus was very common in patients with infectious chronic sinusitis (25%) as well as in non-infectious rhinitis (about 23%) and healthy subjects (40%). The culture of samples in the transport medium did not differ significantly. However, sinus washes appeared to be most reliable. Apart from Staphylococcus aureus, the culture of routine sample did not revealed any of pathogenic strain indicated above.
In conclusion, these results prove similar diagnostic value of samples obtained at various sites, with different methods applied if appropriate transport and storing procedures are followed.
Alergia Astma Immunol 2000: 5(1): 57-63

keywords: przewlekłe zapalenie zatok, bakteriologia, posiewy bakteriologiczne, popłuczyny nosa i zatok, antybiotykoterapia, chronic sinusitis, bacteriology, cultures, nasal washes, sinus puncture, antimicrobial therapy

pages: from 57 to 63

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