[Bacteriological study on adult chronic sinusitis operated after endoscopic sinus surgery].

OBJECTIVE

To explore the bacteria isolated from middle nasal meatus, maxillary sinus, ethmoid sinus and postoperative cavity of patients with chronic rhinosinusitis and their characteristics of antibiotic resistance.

METHODS

Eighty-seven patients with chronic rhinosinusitis were operated on by ESS to obtain the pus specimen for bacterial culture and antibiotic susceptibility test, before and 1 month, 3 months and 6 months after operation.

RESULTS

Totally 645 strains (26 species) of bacteria were detected in 464 specimens [total positive rate was 78.9% (366/464)], in which aerobic bacteria was 95.3% (615/645). Gram negative bacteria and gram positive bacteria were 51.2% (330/645) and 48.8% (315/645), respectively. There was supernumerary tendency in detectable rate of gram negative bacteria isolated from postoperative groups. The main pathogens of postoperative patients were gram negative bacteria, with Enterobacter aerogenes, Pseudomonas aeruginosa and Hemophilus influenza occupying the first 3 places. The detectable rate of multiple drug resistance bacteria in postoperative group was much higher than preoperative groups, in which gram negative bacteria was the most, especially for Pseudomonas aeruginosa. There was significant difference in beta-lactamase detectable rate of the bacteria isolated from the delayed recovery group and the preoperative group (chi2 = 4.85, P < 0.05), Enterobacteriaceae occupied the first place among the beta-lactamase detectable bacteria isolated from the delayed recovery group. There was no significant difference in detectable rate of kinds of bacteria isolated from recovery group and control group.

CONCLUSIONS

The main pathogens of patients with chronic rhinosinusitis are multiple drug resistance gram negative bacteria after operation, in which Pseudomonas aeruginosa occupies the first place. Gram negative bacteria are becoming the main opportunity pathogenic bacteria, which shows antibiotic resistance. microbial population of postoperative cavity from recovery group are becoming balanced.