Antimicrobial management of chronic sinusitis in children

1995 ◽  
Vol 109 (12) ◽  
pp. 1159-1162 ◽  
Author(s):  
Itzhak Brook ◽  
Paula Yocum
Keyword(s):  
Chronic Sinusitis ◽  
Anaerobic Bacteria ◽  
Therapeutic Change ◽  
Response To Therapy ◽  
Rapid Response ◽  
Surgical Drainage ◽  
Antimicrobial Management ◽  
Aerobic And Anaerobic ◽  
Culture Positive

AbstractThis study retrospectively investigated the microbiology and management of 40 children who suffered from chronic sinusitis.The sinuses infected were the maxillary (15 cases), ethmoid (13), and frontal (seven). Pansinusitis was present in five patients. All aspirates were cultured for aerobic and anaerobic bacteria. A total of 121 isolates (97 anaerobic and 24 aerobic) were recovered. Anaerobes were recovered from all 37 culture- positive specimens, and in 14 cases (38 per cent) they were mixed with aerobes. Twenty-three 3- lactamase-producing bacteria were isolated from 16 (43 per cent) patients. The 15 patients who received clindamycin had the most rapid response to therapy and a change of therapy and surgical drainage was required in one case. Of the 16 patients who received amoxycillin or ampicillin, 16 responded to therapy, six needed a change of therapy, including four who also had surgical drainage. Of the six who were treated with erythromycin, three needed antibiotic change, two with surgical drainage. Of the three that received cefaclor, two were cured, and one had an antibiotic change. Resistant organisms were recovered in all the cases that required therapeutic change.These findings support the important role of anaerobic bacteria in the polymicrobial cause of chronic sinusitis in children, and the superiority of therapy effective against these organisms.

Bacteriology of Chronic Maxillary Sinusitis in Adults

1989 ◽  
Vol 98 (6) ◽  
pp. 426-428 ◽  
Author(s):  
Itzhak Brook
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Anaerobic Bacteria ◽  
Chronic Maxillary Sinusitis ◽  
Aerobic And Anaerobic ◽  
And Staphylococcus Aureus ◽  
Culture Positive ◽  
Maxillary Sinuses

Aspirates of 72 chronically inflamed maxillary sinuses were processed for aerobic and anaerobic bacteria. Bacterial growth was present in 66 of the 72 specimens (92%). Anaerobic bacteria were isolated in 58 of the 66 culture-positive specimens (88%). Anaerobes only were recovered in 37 cases (56%) and in 21 (32%) they were mixed with aerobic or facultative bacteria. Aerobic or facultative bacteria were present in eight cases (12%). A total of 185 isolates (2.8 per specimen) — 131 (2.0 per specimen) anaerobes and 54 (0.8 per specimen) aerobes or facultatives — were isolated. The predominant anaerobic organisms were anaerobic cocci and Bacteroides sp, and the predominant aerobes or facultatives were Streptococcus sp and Staphylococcus aureus. Twelve of the 27 Bacteroides sp that were tested for β-lactamase (44%) produced the enzyme. These findings indicate the major role of anaerobic organisms in chronic sinusitis.

The Role of Anaerobic Bacteria in Perinephric and Renal Abscesses in Children

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 261-264
Author(s):  
Itzhak Brook
Keyword(s):  
Renal Transplant ◽  
Abdominal Surgery ◽  
Anaerobic Bacteria ◽  
Renal Abscess ◽  
Previous Abdominal Surgery ◽  
Aerobic And Anaerobic

Objective. To investigate the aerobic and anaerobic microbiology of renal abscesses in children. Patients and methods. Aspirates from six children with perinephric and four with renal abscess were cultured for aerobic and anaerobic bacteria. Results. A total of 20 organisms were recovered, 8 aerobic or facultative bacteria and 12 anaerobic bacteria. Aerobic or facultative bacteria only were recovered in one patient, anaerobic bacteria only in two, and mixed aerobic and anaerobic bacteria in seven. Anaerobic bacteria were isolated in perinephric abscesses that were associated with previous abdominal surgery and renal transplant and in renal abscesses that were related to malignancy, pyelonephritis, and orodental infection. Conclusion. This study highlights the importance of anaerobic bacteria in perinephric and renal abscesses in children.

scholarly journals Anaerobic osteomyelitis

2021 ◽  
Vol 2 (3) ◽  
pp. 494-500
Author(s):  
H. A. Mousa ◽  
S. S. Bakr ◽  
Thamer A. Haman
Keyword(s):  
Prospective Study ◽  
Anaerobic Bacteria ◽  
Bone Infection ◽  
Anaerobic Conditions ◽  
Long Duration ◽  
Pyogenic Osteomyelitis ◽  
Aerobic And Anaerobic ◽  
Aerobic And Anaerobic Conditions ◽  
Better Than

The prevalence and role of anaerobic bacteria in bone infection were investigated in this prospective study on 134 cases with pyogenic osteomyelitis. Specimens were inoculated immediately in the operating theatre or in the ward and incubated under aerobic and anaerobic conditions without using transport media. Anaerobic organisms were isolated from 39 of the 134 cases [29%] of all types of pyogenic osteomyelitis. The total number of aerobic and anaerobic isolates was 224, of which 50 were anaerobes [22%]. Syringe-aspirated specimens were better than swab specimens for the isolation of anaerobes. Anaerobes were mostly isolated from osteomyelitis cases of long duration

The Microbiology of Serous and Mucoid Otitis Media

PEDIATRICS ◽  
1979 ◽  
Vol 63 (6) ◽  
pp. 915-919
Author(s):  
G. Scott Giebink ◽  
Elaine L. Mills ◽  
John S. Huff ◽  
Charlene K. Edelman ◽  
Marcia L. Weber ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Mycoplasma Pneumoniae ◽  
Staphylococcus Epidermidis ◽  
Anaerobic Bacteria ◽  
Positive Culture ◽  
Aerobic Bacteria ◽  
Viral Isolate ◽  
Aerobic And Anaerobic ◽  
Culture Positive

One hundred forty-four serous and mucoid effusions were cultured for aerobic and anaerobic bacteria, Mycoplasma pneumoniae, and virus. Thirty percent of all effusions yielded an unequivocally positive culture for aerobic bacteria. Although serous effusions were culture positive as often as mucoid effusions, Haemophilus influenzae was isolated predominantly from serous effusions and Staphylococcus epidermidis predominantly from mucoid samples. Only one of 73 effusions yielded a viral isolate (Herpesvirus honiinis). None of 33 effusions yielded M pneumoniae, and only one of 17 effusions yielded an anaerobe (Propionibacterium). These findings suggest that aerobic bacteria may play a role in the pathogensis of serous and mucoid otitis media.

scholarly journals Microbiology and antimicrobial management of sinusitis

2005 ◽  
Vol 119 (4) ◽  
pp. 251-258 ◽  
Author(s):  
Itzhak Brook
Keyword(s):  
Chronic Sinusitis ◽  
Anaerobic Bacteria ◽  
Allergic Inflammation ◽  
Acute Sinusitis ◽  
High Dose ◽  
Beta Lactamase ◽  
Upper Respiratory Tract ◽  
Penicillin Therapy ◽  
Antimicrobial Management ◽  
Potential Pathogen

Sinusitis generally develops as a complication of viral or allergic inflammation of the upper respiratory tract. The bacterial pathogens in acute sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, while anaerobic bacteria and Staphylococcus aureus are predominant in chronic sinusitis. Pseudomonas aeruginosa has emerged as a potential pathogen in immunocompromised patients and in those who have nasal tubes or catheters, or are intubated. Many of these organisms recovered from sinusitis became resistant to penicillins either through the production of beta-lactamase (H. influenzae, M. catarrhalis, S. aureus, Fusobacterium spp., and Prevotella spp) or through changes in the penicillin-binding protein (S. pneumoniae). The pathogenicity of beta-lactamase-producing bacteria is expressed directly through their ability to cause infections, and indirectly through the production of betalactamase. The indirect pathogenicity is conveyed not only by surviving penicillin therapy, but also by ‘shielding’ penicillin-susceptible pathogens from the drug. The direct and indirect virulent characteristics of these bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections. The antimicrobials that are the most effective in management of acute sinusitis are amoxycillin-clavulanate (given in a high dose), the newer quinolones (gatifloxacin, moxifloxacin) and the second generation cephalosporins (cefuroxime, cefpodoxime, cefprozil or cefdinir). The antimicrobials that are the most effective in management of chronic sinusitis are amoxycillinclavulanate, clindamycin and the combination of metronidazole and a penicillin.

Effect of radiation dose on the recovery of aerobic and anaerobic bacteria from mice

1986 ◽  
Vol 32 (9) ◽  
pp. 719-722 ◽  
Author(s):  
Itzhak Brook ◽  
Richard I. Walker ◽  
Thomas J. MacVittie
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Radiation Dose ◽  
Proteus Mirabilis ◽  
Anaerobic Bacteria ◽  
Gram Positive ◽  
Higher Doses ◽  
Aerobic And Anaerobic ◽  
Culture Positive ◽  
Gram Positive Cocci

The presence of aerobic and anaerobic bacteria in the blood, spleen, and liver was investigated in mice that were exposed to 7, 8, 9, or 10 Gy 60Co radiation. Microorganisms were detected more often in animals exposed to higher doses of radiation. The number of mice that were culture positive and the number of isolates in one site increased with increasing dose. Bacteria were recovered in mice killed at various times after radiation, in 3 of 100 mice exposed to 7 Gy, in 13 of 100 irradiated with 8 Gy, in 23 of 90 exposed to 9 Gy, and in 34 of 87 irradiated with 10 Gy. The predominant organisms recovered were Escherichia coli, anaerobic Gram-positive cocci, Proteus mirabilis, Staphylococcus aureus, and Bacteroides spp. Escherichia coli and anaerobes were more often isolated in animals exposed to 10 Gy, while S. aureus was more often recovered in those irradiated with 9 Gy. These data demonstrate a relationship between the dose of radiation and the rate of infection due to enteric aerobic and anaerobic bacteria.

Role of Anaerobes in Chronic Sinusitis: Will Polymerase Chain Reaction Solve the Debate

2002 ◽  
Vol 127 (5) ◽  
pp. 384-386 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Peter H. Mathers ◽  
Heather Schwartzbauer
Keyword(s):  
Chronic Rhinosinusitis ◽  
Chronic Sinusitis ◽  
Anaerobic Bacteria ◽  
Sinus Surgery ◽  
Pcr Analysis ◽  
Chain Reaction ◽  
Culture Techniques ◽  
Standard Culture ◽  
Polymerase Chain

BACKGROUND: Bacteriology of chronic sinusitis continues to be a matter of debate, particularly the role of anaerobes. Some authors suggest that anaerobes play a significant role whereas others suggest a minimal role. Those who suggest a significant role argue that standard culture techniques are the culprits. OBJECTIVE: The purpose of this study was to use polymerase chain reaction (PCR) on sinus specimens for the presence of anaerobes and to compare them with standard culture techniques. METHODS: Sixty-four samples were obtained in a sterile fashion during sinus surgery and were sent for standard anaerobic cultures as well as anaerobic PCR analysis. RESULTS: Anaerobic bacteria were demonstrated in 5% of culture specimens, which is similar to recently published data. PCR identified anaerobic bacteria in 19% of the specimens ( P = 0.01) CONCLUSION: PCR analysis of surgical samples obtained during endoscopic sinus surgery for chronic sinusitis identified a significantly higher incidence of anaerobes (x4) compared with standard anaerobic culture technique. Chronic rhinosinusitis is one of the most common chronic diseases that affects individuals in the United States. It is estimated that >25 million office visits are made for sinusitis. 1 The financial impact of chronic sinusitis includes not only the direct medical costs of treatment but also the millions of hours of lost productivity caused by the disease. 1 Chronic rhinosinusitis is defined as the signs and symptoms of sinus inflammation that last longer than 12 weeks associated with documented sinus inflammation with imaging techniques ≥4 weeks after appropriate antibiotic therapy. 2 There is agreement in the literature regarding the bacterial etiology of acute rhinosinusitis. However, the etiology of chronic rhinosinusitis is still unclear despite numerous articles about the bacteriology of chronic rhinosinusitis. 3–10 The role of aerobes is more clear than the role of anaerobes in chronic rhinosinusitis; many conflicting reports have been published about the role of anaerobes as etiologic factors in chronic rhinosinusitis. 3–10 The incidence of anaerobes obtained on standard cultures from patients with chronic rhinosinusitis ranges from 0% to 56%. 3–10 The reports that show a high yield of anaerobes argue that the technique used to obtain the specimens, the method of transportation, and even specimen collection are reasons why other reports did not yield high levels of anaerobes. 4–5 With increasing numbers of patients with chronic rhinosinusitis and with increasing bacterial resistance to antimicrobials, which is blamed on the improper use of antimicrobials, knowledge of the bacteriology becomes important in the treatment. The role of aerobes was addressed in a prior publication 11 ; the role of anaerobic bacteria as an etiologic cause of chronic rhinosinusitis is addressed in this report. The goal of this study was to test specimens, using 2 different techniques, obtained during endoscopic sinus surgery from individuals who had chronic rhinosinusitis.

Intracranial Complications of Sinusitis in Children

1982 ◽  
Vol 91 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Itzhak Brook ◽  
Ellen M. Friedman
Keyword(s):  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Anaerobic Bacteria ◽  
The Other ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
Periapical Abscess ◽  
Intracranial Complications ◽  
Maxillary Sinuses

The cases of two children with periapical abscess in the upper incisors, sinusitis, and intracranial abscess are described. The ethmoid and maxillary sinuses were involved in both patients. Subdural empyema occurred in both, and one of the children had also cerebritis and brain abscess. Anaerobic bacteria were isolated from the infected subdural empyemas. Peptostreptococcus intermedius and microaerophilic streptococci were recovered in one patient and Fusobacterium sp in the other. Surgical drainage and appropriate antimicrobial therapy resulted in complete eradication of the infection in both patients. The role of anaerobic bacteria and the therapy directed against them in periapical abscess and the sinusitis and intracranial abscess which follow are discussed.

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