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Nosocomial sinusitis with isolation of anaerobic bacteria in ICU patients.

Abstract：

OBJECTIVE:To determine the frequency and the eventual clinical characteristics of nosocomial sinusitis with anaerobic bacteria isolation in patients in the intensive care unit (ICU). DESIGN:Retrospective study. SETTING:A 12-bed medical ICU in a teaching hospital. PATIENTS:30 adult patients with documented nosocomial maxillary sinusitis. INTERVENTIONS:None. MEASUREMENTS AND RESULTS:Using appropriate microbiological techniques, 33 anaerobic bacterial strains were isolated in 18/30 patients (60 %) with nosocomial sinusitis. Anaerobic bacteria were associated with aerobic strains in 13 patients (72 %), whereas in 5 patients (28 %) only anaerobic strains were isolated in sinus puncture cultures. The most frequently isolated species were Prevotella sp. (n = 20, 60 %) and Fusobacterium nucleatum (n = 5, 15 %). The production of beta -lactamase was demonstrated in 13/27 gram-negative anaerobic bacteria. All patients in whom anaerobic bacteria were isolated from transnasal punctures had had a nasogastric tube. Patients in whom anaerobic bacteria were isolated more frequently had neurological disorders upon admission (p < 0.02). Ten patients (30 %) had nosocomial pneumonia, 8 of whom had at least one identical strain in both lung and sinus cultures, including 2 patients with anaerobic bacteria isolation. CONCLUSIONS:Using appropriate microbiological techniques, anaerobic bacteria were frequently isolated in nosocomial sinusitis. If necessary, the empirical choice of antimicrobial therapy in patients with nosocomial sinusitis should take into account these results.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Le Moal G,Lemerre D,Grollier G,Desmont C,Klossek JM,Robert R

doi

10.1007/s001340051013

keywords:

subject

Has Abstract

pub_date

1999-10-01 00:00:00

pages

1066-71

issue

10

eissn

0342-4642

issn

1432-1238

pii

90251066.134

journal_volume

25

pub_type

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