Bacteriology and antimicrobial susceptibility of pediatric chronic rhinosinusitis: a 6-year result of maxillary sinus punctures
Received 20 October 2008 published online 31 March 2009.
Abstract
Purpose
Few studies in the past decade have focused on antimicrobial resistance of bacteria in pediatric rhinosinusitis. This study aimed to characterize organisms cultured from pediatric chronic rhinosinusitis, as well as current resistance patterns of pathogens.
Materials and methods
The study was conducted from January 2001 to December 2006. Children with radiograph-proven chronic rhinosinusitis underwent maxillary sinus punctures to obtain pathogens and for analysis of antibiotic resistance.
Results
The total 295 cultures obtained from 165 children yielded 399 isolates. The most common isolates were α-hemolytic Streptococcus (20.8%), Haemophilus influenzae (19.5%), Streptococcus pneumoniae (14.0%), coagulase-negative Staphylococcus (13.0%), and Staphylococcus aureus (9.3%). Anaerobes accounted for 8.0% of all isolates. Susceptibility rates of H influenzae for ampicillin and co-trimoxazole were 44.7% and 42.1%, respectively, in the first 3 years of the study and 25% and 40%, respectively, in the next 3 years. Susceptibility rates of S pneumoniae were 83.3% for penicillin, 0% for erythromycin, and 33.3% for clindamycin in the first 3 years and 73.7%, 5.3%, and 28.9%, respectively, in the latter 3 years.
Conclusion
This study showed a different pattern of antibiotic resistance in pediatric chronic rhinosinusitis as compared with previous studies in both children and adults. The resistance rate of H influenzae for ampicillin appears to be a growing problem in pediatric rhinosinusitis.
aDepartment of Otolaryngology, Chung Shan Medical University Hospital and School of Medicine, Taichung, Taiwan
bDepartment of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Corresponding author. Department of Otolaryngology, National Taiwan University Hospital, 1 Chang-Teh Street, Taipei 10016, Taiwan. Tel.: +886 2 3123456x65224; fax: +886 2 23410905.
ABSTRACT