Bacteriological Study of Chronic Sinusitis with Special Reference to Anaerobes

Abstract

Background and objective :- ABSTRACT Chronic sinusitis afflicts significant percentage of the population and causes considerable long term morbidity. Objective is to isolate and speciate aerobic and anaerobic bacteria from clinically diagnosed cases of chronic sinusitis and to determine the antibiotic susceptibility pattern of aerobic organisms. Material and methods :- The study included 50 patients with signs and symptoms of chronic sinusitis over a period of one year ( Jan 2007-Jan 2008) . Material was collected from chronically inflamed sinuses during FESS. Clinical samples were transported to the laboratory in fluid thioglycollate media. The macroscopic and microscopic findings were noted. Aerobic and anaerobic cultures were put up. For aerobic, 5% blood agar, mac conkey agar and chocolate agar ( 5-10% co2 ) media were used and for anaerobic, blood agar with haemin and vitamin K, Kanamycin, Vancomycin laked blood agar ( KVLB ) and Bacteroides Bile Esculin agar ( BBE ) . The media were placed in McIntosh Fildes jar with Iternal Gas Generating System and incubated at 37 0 C for minimum of 3-5 days. Anaerobic growth was identified using standard techniques. Antibiotic sensitivity testing of aerobic organisms were carried out by the Kirby Bauer’s disk diffusion technique. Results :- Bacterial growth was present in 33 of the 50 samples. Only aerobes were obtained in 17 ( 34% ) samples, pure anaerobes in 9 ( 18% ) cases. Anaerobic growth was totally seen in 16 ( 32% ) of the samples, no growth was seen in 17 ( 32% ) of the XI samples. Of the aerobes Staplylococus aureus was the commonest isolate and in anaerobes Prevotella species were the commonest isolate followed by by Bacteroides species. Conclusion:- Although aerobes are commonly isolated in chronic sinusitis, anaerobes also play a important role in chronically inflamed sinuses and therefore appropriate therapy should be directed at these anaerobes as well, as early as possible to decrease the long term morbidity of this disease.