Jousimies-Somer H R, Savolainen S, Ylikoski J S
Anaerobe Reference Unit, National Public Health Institute, Helsinki, Finland.
J Clin Microbiol. 1989 Dec;27(12):2736-43. doi: 10.1128/jcm.27.12.2736-2743.1989.
The nasal bacterial flora was studied in 183 healthy men entering military service (entry group), 103 healthy recruits in service (service group), and 185 recruits with acute maxillary sinusitis. The 267 nasal and ipsilateral sinus aspirate findings in the same patients with acute maxillary sinusitis were compared pairwise. In the entry group presumed sinus pathogens were only rarely isolated from the nasal cavities: Haemophilus influenzae in 4%, Streptococcus pneumoniae in 1%, Branhamella catarrhalis in 3%, and Streptococcus pyogenes in 0%. The corresponding isolation frequencies in the service group were 19, 13, 3, and less than 1%, respectively, and those in the group with acute maxillary sinusitis were 61, 25, 7, and 6%, respectively. Suppression of the major components of the normal nasal flora, Corynebacterium sp., coagulase-negative staphylococci, Propionibacterium acnes, and Staphylococcus aureus, was seen in the group with acute maxillary sinusitis and also occasionally in the service group. When a sinus aspirate culture yielded a presumed sinus pathogen, the same pathogen was found in the nasal samples in 91% of the cases. The predictive value of a pathogen-positive nasal finding was highest (93.8%) for S. pyogenes, followed by 77.7% for H. influenzae and 68.7% for S. pneumoniae, and lowest (20%) for B. catarrhalis.
对183名刚入伍的健康男性（入伍组）、103名现役健康新兵（服役组）以及185名患有急性上颌窦炎的新兵的鼻腔细菌菌群进行了研究。对患有急性上颌窦炎的同一批患者的267份鼻腔及同侧鼻窦抽吸物检查结果进行了两两比较。在入伍组中，鼻腔中仅很少分离出推测的鼻窦病原体：流感嗜血杆菌占4%，肺炎链球菌占1%，卡他莫拉菌占3%，化脓性链球菌占0%。在服役组中，相应的分离频率分别为19%、13%、3%和不到1%，而在患有急性上颌窦炎的组中分别为61%、25%、7%和6%。在患有急性上颌窦炎的组中以及偶尔在服役组中可见正常鼻腔菌群的主要成分棒状杆菌属、凝固酶阴性葡萄球菌、痤疮丙酸杆菌和金黄色葡萄球菌受到抑制。当鼻窦抽吸物培养产生推测的鼻窦病原体时，91%的病例在鼻腔样本中发现相同的病原体。鼻腔发现病原体阳性对化脓性链球菌的预测价值最高（93.8%），其次流感嗜血杆菌为77.7%，肺炎链球菌为68.7%，卡他莫拉菌最低（20%）。
