Aerobic bacteria and fungal isolates in maxillary sinusitis of adults in a resource poor environment

Abstract

Background: Infective rhinosinusitis is a common clinical condition which if left unattended to could result in various degrees of both morbidity and mortality. We aimed to identify aerobic and fungal organisms implicated in acute and chronic maxillary sinusitis and determine their antibiotic sensitivity patterns among adults in South Western Nigeria.

Materials and methods: This was a cross sectional study of adults with clinical and radiological diagnosis of maxillary sinusitis treated at the University College Hospital, Ibadan over a period of one-year. Semi- structured questionnaire was administered to each consented adult to obtain relevant demographic and clinical data. Maxillary antral proof puncture was done to obtain specimen for microscopy, culture and sensitivity for aerobic bacterial and fungal isolates. Descriptive statistics was used in the data analysis.

Results: Seventy-nine patients (49.4% males and 50.6% females) with acute maxillary sinusitis (17.7%), and chronic maxillary sinusitis (82.3%) were recruited into the study. The mean age of the patients was 32.9 years (SD=12.78; Range: 19- 59). All patients presented with rhinorrhea while 92.8% had nasal obstruction. Fifty eight (73.4%) patients had history of antibiotic usage before presentation. Eight (57.1%) of the specimens from acute maxillary sinusitis cases and 40 (61.5%) of the specimens from chronic maxillary sinusitis yielded significant growth of bacteria and fungi respectively while 2 (3.5%) yielded mixed bacterial growth. Organisms commonly isolated from these specimens were Streptococcus pneumonia, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenzae, and Aspergillus spp. The bacteria isolates were sensitive to Amoxicillin, Ciprofloxacin, Perfloxacin, Sparfloxacin and Ceftriaxone.

Conclusion: The leading aerobic bacterial isolates from acute and chronic maxillary sinusitis were Streptococcus pneumonia and Staphylococcus aureus respectively. Fungal infections are seen only in chronic cases. It is recommended that where there are no microbiologic laboratory facilities, any of Ciprofloxacin, Perfloxacin, Sparfloxacin, and Amoxicillin can be administered empirically to treat infective maxillary sinusitis.

Keywords: Aerobic bacteria, Fungus, Maxillary sinus, Rhinosinusitis