Microbiology of acute sinusitis of odontogenic origin presenting with periorbital cellulitis in children.

Microbiology of acute sinusitis of odontogenic origin presenting with periorbital cellulitis in children.

Ann Otol Rhinol Laryngol. 2007 May

Brook I.
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.

OBJECTIVES: This study was undertaken to evaluate the aerobic and anaerobic microbiology of acute maxillary sinusitis of odontogenic origin presenting with periodontal infection in children.

METHODS: Aspirates of 18 acutely infected maxillary sinuses that were associated with odontogenic infection in children who presented with periorbital cellulitis were processed for aerobic and anaerobic bacteria.

RESULTS: A total of 54 isolates were recovered (3.0 per specimen): 13 aerobic and facultative (0.7 per specimen) and 41 anaerobic (2.3 per specimen). The number of isolates per specimen varied from 1 to 4. Aerobic and facultative organisms alone were recovered in 2 specimens (11%), anaerobes only in 7 (39%), and mixed aerobic and anaerobic bacteria in 9 (50%). The predominant aerobic and facultative organisms were alpha-hemolytic streptococci (4), microaerophilic streptococci (3), and Streptococcus pyogenes and Staphylococcus aureus (2 each). The predominant anaerobic bacteria were anaerobic gram-negative bacilli (17), Peptostreptococcus spp (11), Fusobacterium spp (8), and Propionibacterium acnes (2). Twelve beta-lactamase-producing bacteria were recovered from 9 specimens (50%).

CONCLUSIONS: This study demonstrates the unique aerobic and anaerobic microbiological features of acute maxillary sinusitis of odontogenic origin presenting with periorbital cellulitis in children.

PMID: 17561769 [PubMed - in process]

Bacteriology of chronic sinusitis and acute exacerbation of chronic sinusitis

Arch Otolaryngol Head Neck Surg. 2006 Oct

Brook I.
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC 20016, USA. ib6@georgetown.edu

OBJECTIVE: To establish the microbiological characteristics of acute exacerbation of chronic sinusitis (AECS).

SETTING: Academic medical center.

PATIENTS: Thirty-two patients with chronic sinusitis and 30 patients with AECS.

MAIN OUTCOME MEASURE: The aerobic and anaerobic microbiology of maxillary AECS and chronic maxillary sinusitis.

RESULTS: A total of 81 isolates (33 aerobic and 48 anaerobic) were recovered from the 32 cases (2.5 per specimen) with chronic sinusitis. Aerobes alone were recovered in 8 specimens (25%), anaerobes only were isolated in 11 (34%), and mixed aerobes and anaerobes were recovered in 13 (41%). The predominant aerobic and facultative bacteria were Enterobacteriaceae and Staphylococcus aureus. The predominant anaerobic bacteria were Peptostreptococcus subspecies, Fusobacterium subspecies, anaerobic gram-negative bacilli, and Propionibacterium acnes.

Twenty-one beta-lactamase-producing bacteria were recovered from 17 specimens (53%). A total of 89 isolates (40 aerobic and facultatives, and 49 anaerobic) were recovered from the 30 patients (3.0 per specimen) with AECS. Aerobes were recovered in 8 instances (27%), anaerobes only in 11 (37%), and mixed aerobes and anaerobes were recovered in 11 (37%). The predominant aerobes were Streptococcus pneumoniae, Enterobacteriaceae, and S aureus. The predominant anaerobes were Peptostreptococcus subspecies, Fusobacterium subspecies, anaerobic gram-negative bacilli, and P acnes. Thirty-six beta-lactamase-producing bacteria were recovered from 28 specimens (53%).

CONCLUSIONS: This study demonstrates that the organisms isolated from patients with AECS were predominantly anaerobic and were similar to those generally recovered in patients with chronic sinusitis. However, aerobic bacteria that are usually found in acute infections (eg, S pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis) can also emerge in some of the episodes of AECS.

Journal of Otolaryngology