Brook I, Yocum P, Frazier E H
Department of Pediatrics, Naval Medical Center, Bethesda, Md., USA.
Arch Otolaryngol Head Neck Surg. 1996 Apr;122(4):418-22; discussion 423. doi: 10.1001/archotol.1996.01890160058011.
To assess the bacteriology and beta-lactamase enzyme activity in aspirates of 10 acutely and 13 chronically inflamed maxillary sinuses.
The predominant organisms isolated in acute sinusitis were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, and those found in chronic sinusitis were Prevotella species, Fusobacterium species, and Peptostreptococcus species. Four beta-lactamase-producing organisms (BLPOs) were isolated in four specimens (40%) obtained from acutely inflamed sinuses, and 14 BLPOs were recovered from 10 chronically inflamed sinuses (77%). The predominant BLPOs in acute sinusitis were H influenzae, and M catarrhalis; those in chronic sinusitis were Staphylococcus aureus, Prevotella species, Fusobacterium species, and Bacteroides fragilis.
Beta-lactamase activity was detected in 12 (three in acute and nine in chronic sinusitis) of the 14 aspirates that contained BLPOs. The detection of beta-lactamase activity in sinus aspirates provides support for the role of BLPOs in the failure of penicillin therapy in sinusitis.
评估10例急性上颌窦炎和13例慢性上颌窦炎吸出物中的细菌学及β-内酰胺酶活性。
急性鼻窦炎中分离出的主要微生物为肺炎链球菌、流感嗜血杆菌和卡他莫拉菌，慢性鼻窦炎中发现的主要微生物为普雷沃菌属、梭杆菌属和消化链球菌属。从4份急性炎症鼻窦标本（40%）中分离出4株产β-内酰胺酶的微生物（BLPOs），从10份慢性炎症鼻窦标本中分离出14株BLPOs（77%）。急性鼻窦炎中主要的BLPOs为流感嗜血杆菌和卡他莫拉菌；慢性鼻窦炎中的为金黄色葡萄球菌、普雷沃菌属、梭杆菌属和脆弱拟杆菌。
在14份含有BLPOs的吸出物中，12份检测到β-内酰胺酶活性（急性鼻窦炎3份，慢性鼻窦炎9份）。鼻窦吸出物中β-内酰胺酶活性的检测为BLPOs在鼻窦炎青霉素治疗失败中的作用提供了支持。
