Penttilä M, Savolainen S, Kiukaanniemi H, Forsblom B, Jousimies-Somer H
Department of Otorhinolaryngology, Tampere University Hospital, Finland.
Acta Otolaryngol Suppl. 1997;529:165-8.
Bacteriology of acute maxillary sinusitis was studied in 569 patients in 16 centers of 6 countries located throughout Europe during 1992-1994 by ENT specialists. Patients with symptoms of acute sinusitis lasting less than 3 weeks with ongoing purulent nasal discharge were included. Diagnosis was verified by sinus x-ray or ultrasonography and a positive aspiration finding in maxillary sinus puncture. One or more pathogens were isolated from the maxillary sinus aspirates of 375 (66%) patients. Fifty-six percent of patients harboured 1 pathogen and 10% multiple pathogenic organisms, respectively. Haemophilus influenzae was the most common pathogen isolated (148 isolates), occurring as a single pathogen in 14% of the patients. The occurrence of H. influenzae was highest in Finnish military hospital patients (43-48%), as compared with the non-military Finnish patients (9-11%) or to patients from other European centers (mean 13%). H. influenzae was more frequently beta-lactamase positive in other European centers (22%) than in Finnish centers (7%). Streptococcus pneumoniae was the most common pathogen isolated in other European centers (20%) but second most common in Finnish centers (13%). Moraxella catarrhalis occurred at quite similar frequency among Finnish centers (9-14%), but clearly less often in other centers (mean 4%). S. aureus, which in acute maxillary sinusitis is regarded as a contaminant from the nasal cavity, was more prevalent in other European centers (12%) than in Finnish centers (4%). In patients with acute maxillary sinusitis reliable bacteriological samples should be taken by antral aspiration directly from the diseased sinus.
1992年至1994年期间，欧洲6个国家16个中心的耳鼻喉科专家对569例患者的急性上颌窦炎细菌学进行了研究。纳入了急性鼻窦炎症状持续时间少于3周且伴有持续脓性鼻涕的患者。通过鼻窦X光或超声检查以及上颌窦穿刺抽吸结果阳性来确诊。375例（66%）患者的上颌窦抽吸物中分离出一种或多种病原体。分别有56%的患者携带1种病原体，10%的患者携带多种致病微生物。流感嗜血杆菌是分离出的最常见病原体（148株），在14%的患者中作为单一病原体出现。与非军事芬兰患者（9 - 11%）或其他欧洲中心的患者（平均13%）相比，流感嗜血杆菌在芬兰军事医院患者中的发生率最高（43 - 48%）。在其他欧洲中心，流感嗜血杆菌产β - 内酰胺酶的频率（22%）高于芬兰中心（7%）。肺炎链球菌是其他欧洲中心分离出的最常见病原体（20%），但在芬兰中心是第二常见病原体（13%）。卡他莫拉菌在芬兰各中心的发生率相当（9 - 14%），但在其他中心明显较低（平均4%）。在急性上颌窦炎中被视为鼻腔污染物的金黄色葡萄球菌，在其他欧洲中心（12%）比在芬兰中心（4%）更普遍。对于急性上颌窦炎患者，应通过窦腔抽吸直接从患病鼻窦获取可靠的细菌学样本。
