Zhang Zi, Adappa Nithin D, Doghramji Laurel J, Chiu Alexander G, Cohen Noam A, Palmer James N
Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Int Forum Allergy Rhinol. 2015 Aug;5(8):724-33. doi: 10.1002/alr.21532. Epub 2015 Apr 21.
Staphylococcus aureus and Pseudomonas aeruginosa are common culture isolates in chronic rhinosinusitis (CRS). We aimed to determine whether they were associated with different clinical factors of CRS.
Adult CRS patients who underwent functional endoscopic sinus surgery (FESS) between October 1, 2007 and December 31, 2011 were recruited. Patient demographics, Lund-Mackay computed tomography (CT) scores, 22-item Sino-Nasal Outcome Test (SNOT-22) scores, disease characteristics, and medication use were collected prior to FESS. Intraoperative culture was obtained in a standard manner. We compared patients with isolates of S. aureus or P. aeruginosa to patients with other culture results and no bacterial growth, respectively. Multivariate logistic regression was performed.
A total of 376 patients met criteria; 104 patients (28%) had S. aureus, 32 (9%) had P. aeruginosa, and 10 patients (3%) had no bacterial growth. After adjusting for all clinical factors, compared to patients with positive culture other than S. aureus, patients with S. aureus had 1.9 times increased odds of having nasal polyps (odds ratio [OR] = 1.9; 95% confidence interval [CI], 1.0 to 3.3; p = 0.036); when compared to patients with positive culture other than P. aeruginosa, patients with P. aeruginosa had 7.8 times increased odds of having prior FESS (OR = 7.8; 95% CI, 2.1 to 28.9; p = 0.002) (91% vs 58%; p < 0.001) and 3.6 times increased odds of having diabetes with marginal significance (OR = 3.6; 95% CI, 1.0 to 13.2; p = 0.053). The sample size in the no bacterial growth group was too small to draw firm conclusions.
S. aureus was more common in CRS patients with nasal polyps, whereas P. aeruginosa was more common in CRS patients with prior FESS history and possibly diabetes.
金黄色葡萄球菌和铜绿假单胞菌是慢性鼻-鼻窦炎（CRS）常见的培养分离菌。我们旨在确定它们是否与CRS的不同临床因素相关。
招募了2007年10月1日至2011年12月31日期间接受功能性鼻内镜鼻窦手术（FESS）的成年CRS患者。在FESS术前收集患者的人口统计学资料、Lund-Mackay计算机断层扫描（CT）评分、22项鼻-鼻窦结局测试（SNOT-22）评分、疾病特征和用药情况。术中以标准方式进行培养。我们分别将分离出金黄色葡萄球菌或铜绿假单胞菌的患者与培养结果为其他情况及无细菌生长的患者进行比较。进行多因素逻辑回归分析。
共有376例患者符合标准；104例患者（28%）分离出金黄色葡萄球菌，32例（9%）分离出铜绿假单胞菌，10例患者（3%）无细菌生长。在对所有临床因素进行校正后，与培养结果为非金黄色葡萄球菌阳性的患者相比，分离出金黄色葡萄球菌的患者患鼻息肉的几率增加了1.9倍（比值比[OR]=1.9；95%置信区间[CI]，1.0至3.3；p=0.036）；与培养结果为非铜绿假单胞菌阳性的患者相比，分离出铜绿假单胞菌的患者既往接受FESS的几率增加了7.8倍（OR=7.8；95%CI，2.1至28.9；p=0.002）（91%对58%；p<0.001），患糖尿病的几率增加了3.6倍，具有边缘统计学意义（OR=3.6；95%CI，1.0至13.2；p=0.053）。无细菌生长组的样本量太小，无法得出确切结论。
金黄色葡萄球菌在患有鼻息肉的CRS患者中更为常见，而铜绿假单胞菌在有FESS病史且可能患有糖尿病的CRS患者中更为常见。
