Irfandy D, Hafiz A, Budiman B J, Andrianingsih A
Division of Rhinology, Otorhinolaryngology Department, Faculty of Medicine-Universitas Andalas/ Dr. M. Djamil General Hospital Padang, Indonesia.
Medical Student, Faculty of Medicine, Universitas Andalas, Padang Indonesia.
Med J Malaysia. 2023 Jul;78(4):466-471.
Chronic rhinosinusitis (CRS) is an inflammation of the nasal mucosa and paranasal sinuses for more than 3 months that affects 5 to 12% of the quality of life. Antibiotics are the first line of management for CRS. Increased antibiotic resistance causes ineffective treatment of CRS. This study aims to determine the bacterial pattern that causes CRS before and during the COVID-19 pandemic. Culture sensitivity tests in rhinosinusitis patients were conducted to see changes in the bacterial resistance patterns to antibiotics before and during the COVID-19 pandemic and to determine the appropriate use of antibiotics and prevent an increase in antibiotic resistance in the ENT-HNS outward department of RSUP Dr. M. Djamil Padang.
The type of research was a retrospective study with a total sample of 174 CRS patients who had undergone culture and sensitivity tests. The study population was all CRS patients who were treated at the ENT-HNS outward department at RSUP DR. M. Djamil Padang from 2016 to 2021, underwent surgery and received antibiotic treatment at secondary health services. Antibiotic sensitivity cultures are required for surgery and to determine antibiotics use after surgery. This research was conducted from February to May at the Tertiary Hospital of Dr. M. Djamil Padang. The data collection technique used a total sampling technique. The sample in this study was taken from the medical records of patients at the ENT-HNS outward department of RSUP Dr. M. Djamil Hospital, Padang.
The results showed that the prevalence of CRS with polyps before COVID-19 was 63.8% of cases. After COVID- 19, the prevalence of CRS with polyps was found to be 60% of cases. Before the COVID-19 pandemic, CRS was most common among those aged ≥ 41 to 50 years (27%) and the most common bacteria causing CRS with or without polyps was Staphylococcus aureus (39%; 44%). The bacteria causing CRS with or without polyps after COVID-19 were mostly Staphylococcus epidermidis (50% of cases). Before the COVID-19 pandemic, amoxicillin-clavulanic acid had a high resistance of 75 to 100%, however, after COVID-19 there was a change in antibiotic resistance patterns and an increase in ciprofloxacin resistance of 56 to 100% was obtained.
This change in antibiotic resistance pattern needs attention to prevent drug resistance, especially after COVID-19.
慢性鼻-鼻窦炎（CRS）是鼻黏膜和鼻窦的炎症，持续时间超过3个月，影响5%至12%的生活质量。抗生素是CRS的一线治疗药物。抗生素耐药性增加导致CRS治疗无效。本研究旨在确定2019年冠状病毒病（COVID-19）大流行之前和期间导致CRS的细菌模式。对鼻-鼻窦炎患者进行培养药敏试验，以观察COVID-19大流行之前和期间细菌对抗生素耐药模式的变化，并确定抗生素的合理使用，防止巴东M.贾米勒博士公立医院耳鼻喉-头颈外科门诊抗生素耐药性增加。
本研究为回顾性研究，共有174例接受过培养和药敏试验的CRS患者作为样本。研究人群为2016年至2021年在巴东M.贾米勒博士公立医院耳鼻喉-头颈外科门诊接受治疗、在二级医疗服务机构接受手术并接受抗生素治疗的所有CRS患者。手术及确定术后抗生素使用均需要进行抗生素敏感性培养。本研究于2月至5月在巴东M.贾米勒博士三级医院开展。数据收集技术采用整群抽样技术。本研究的样本取自巴东M.贾米勒医院耳鼻喉-头颈外科门诊患者的病历。
结果显示，COVID-19之前伴息肉的CRS患病率为病例的63.8%。COVID-19之后，伴息肉的CRS患病率为病例的60%。在COVID-19大流行之前，CRS在年龄≥41至50岁的人群中最为常见（27%），导致伴或不伴息肉的CRS最常见的细菌是金黄色葡萄球菌（39%；44%）。COVID-19之后，导致伴或不伴息肉的CRS的细菌大多是表皮葡萄球菌（50%的病例）。在COVID-19大流行之前，阿莫西林-克拉维酸的耐药率高达75%至100%，然而，COVID-19之后，抗生素耐药模式发生了变化，环丙沙星耐药率增加至56%至100%。
这种抗生素耐药模式的变化需要引起关注，以防止耐药性，尤其是在COVID-19之后。
