Prevalence of Etiologic Bacteria and βββββ-lactamase - Producing Bacteria in Acute and Chronic Maxillary Sinusitis at Phramongkutklao Hospital
Greetha Moungthong, MD*, Apichat Suwas, MD*, Suradaj Jaruchida, MD*, Sudaluck Chantaratchada, MSc**, Yupa Phonphok, PhD**, Ram Rangsin, MD, MPH, Dr PH***
Affiliation : * Department of Otolaryngology, Phramongkutklao Hospital ** Department of Microbiology, Phramongkutklao College of Medicine *** Department of Military and Community Medicine, Phramongkutklao College of Medicine
Background : To date, there is an increasing trend of prescribing antibiotics that cover (cid:31)-lactamase - producing
bacteria as the first line drug for sinusitis patients in Thailand. This practice dose not only increases the
treatment cost but might also induce resistance to antimicrobial agents.
Objective : To determine the prevalence of the pathogenic bacteria in acute and chronic maxillary sinusitis
as well as the prevalence of (cid:31)-lactamase - producing bacteria.
Materials and Methods : The maxillary aspiration fluid specimens of 52 acute and chronic sinusitis patients at
Phramongkutklao Hospital, Bangkok, Thailand during May 2002-May 2003, were collected. Aerobic and
anaerobic cultures were performed and the (cid:31)-lactamase activities of isolated bacteria were determined.
Results : Of 58 specimens, 44 (75.9%) and 14 (24.1%) specimens were collected from acute and chronic
maxillary sinusitis patients, respectively. Of 44 specimens of acute maxillary sinusitis, the predominant
isolates were Haemophilus influenzae (13, 29.5%), Streptococcus pneumoniae (4, 9%), Streptococcus viridan
(4, 9%), and Klebsiella pneumoniae (4, 9%). 6 (13.6%) of them were β-lactamase - producing bacteria. Of 14
specimens of chronic maxillary sinusitis, the predominant isolates were Pseudomonas aeruginosa (3, 16.6%),
Staphylococcus spp (3, 17.5%) and Streptococcus spp. (2, 11.6%). 1 (7.1%) Haemophilus influenza isolate
from this group was β-lactamase - producing bacteria. The percentage of anaerobe was 8.9%, 23.3% for
acute and chronic maxillary sinusitis, respectively.
Conclusion : The present study was indicated that the common organisms in acute maxillary sinusitis were
Haemophilus influenzae and Streptococcus pneumoniae, Streptococcus viridians which were similar to a
previous study. But the authors found an increased prevalence of anaerobe bacteria in acute maxillary
sinusitis and also found (cid:31)-lactamase- producing bacteria, 21.4% Hemophilus influenzae less than the previous
studies (which found (cid:31)-lactamase - producing bacteria around 50% to 70%). The authors found 23.3%
anaerobe bacteria in the chronic maxillary sinusitis, less than the previous studies, and the authors also
found 8.9% anaerobe in acute maxillary sinusitis
Keywords : Acute and chronic maxillary sinusitis, (cid:31)-lactamase - producing bacteria
