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.

Acute and Chronic Sinusitis: Diagnosis and Management

1985 ◽  
Vol 7 (5) ◽  
pp. 150-157
Author(s):  
Ellen R. Wald
Keyword(s):  
Paranasal Sinuses ◽  
Chronic Sinusitis ◽  
Clinical Manifestations ◽  
Allergic Inflammation ◽  
Acute Sinusitis ◽  
Upper Respiratory Tract ◽  
Anatomy And Physiology ◽  
Tract Infections ◽  
Ethmoid Sinuses ◽  
Sphenoid Sinuses

Acute (less than 30 days' duration) infections of the paranasal sinuses are seen in children, usually as complication of viral upper respiratory tract infections or allergic inflammation. Chronic (more than 30 days' duration) sinusitis may result when acute sinusitis is not recognized as such or is inadequately treated. Although there are few data on which to base an estimate of the frequency of these disorders, acute sinusitis is commonly encountered in pediatric practice, and chronic sinusitis is not rare. EMBRYOLOGY, ANATOMY, AND PHYSIOLOGY A brief review of the embryology, anatomy, and physiology of the paranasal sinuses will facilitate an understanding of the clinical manifestations of acute and chronic sinusitis. All of the sinuses develop as outpouchings of the nasal mucosa. The maxillary and ethmoid sinuses develop between the third and fifth months of gestation and are pneumatized soon after birth. Although the frontal and sphenoid sinuses also develop during gestation, they remain primitive for several years. The frontal sinuses are not distinct from the anterior ethmoid sinuses until they reach the superior orbital ridge at about 2 years of age; they assume a supraorbital position at 2 to 4 years of age and are in the frontal position at about 6 years of age. The sphenoid sinuses first become well pneumatized at 2 to 3 years of age.

Diagnosis and Management of Anaerobic Infections of the Head and Neck

1992 ◽  
Vol 101 (1_suppl) ◽  
pp. 9-15 ◽  
Author(s):  
Itzhak Brook
Keyword(s):  
Head And Neck ◽  
Postoperative Infection ◽  
Chronic Sinusitis ◽  
Anaerobic Bacteria ◽  
Chronic Otitis Media ◽  
Cervical Adenitis ◽  
Penicillin Therapy ◽  
Bacteroides Fragilis Group ◽  
Anaerobic Infections ◽  
Head And Neck Infections

Anaerobic bacteria are important pathogens in head and neck infections such as chronic otitis media, chronic sinusitis, chronic mastoiditis, head and neck abscesses, cervical adenitis, parotitis, and postoperative infection. Bacteroides sp ( Bacteroides melaninogenicus group, Bacteroides oralis, and Bacteroides fragilis group), Peptostreptococcus sp, and Fusobacterium sp predominate. The observed recent increase in the number of β-lactamase—producing strains of Bacteroides sp isolated in head and neck infections has been associated with increased failure rates of the penicillins in the management of these infections. The pathogenicity of these organisms is expressed through their ability not only to survive penicillin therapy but also to shield penicillin-susceptible pathogens from the drug. Because of these direct and indirect virulent characteristics of anaerobic bacteria, appropriate antimicrobial therapy must be directed against all pathogens in mixed infections.

Microbiology of Acute and Chronic Maxillary Sinusitis in Smokers and Nonsmokers

2011 ◽  
Vol 120 (11) ◽  
pp. 707-712 ◽  
Author(s):  
Itzhak Brook ◽  
Jeffrey N. Hausfeld
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Therapy ◽  
Moraxella Catarrhalis ◽  
Chronic Sinusitis ◽  
Maxillary Sinusitis ◽  
Acute Sinusitis ◽  
Beta Lactamase ◽  
The Past ◽  
Bacteroides Fragilis Group ◽  
Chronic Maxillary Sinusitis

Objectives: We evaluated the microbiology of sinus aspirates of smokers and nonsmokers with acute and chronic maxillary sinusitis. Methods: Cultures were obtained from 458 patients, 244 (87 smokers and 157 nonsmokers) of whom had acute maxillary sinusitis and 214 (84 smokers and 130 nonsmokers) of whom had chronic maxillary sinusitis, between 2001 and 2007. Results: A greater number of Staphylococcus aureus, methicillin-resistant S aureus (MRSA), and beta-lactamase–producing bacteria (BLPB) were found in the 87 smokers with acute sinusitis than in the nonsmokers with acute sinusitis (p < 0.005, p < 0.025, and p < 0.05, respectively). A greater number of these organisms were found in the 84 smokers with chronic sinusitis than in the nonsmokers (p < 0.01, p < 0.025, and p < 0.001, respectively). Eighty-five BLPB isolates were recovered from 73 patients (30%) with acute sinusitis. These included Moraxella catarrhalis, S aureus, Haemophilus influenzae, Prevotella spp, and Fusobacterium spp; 40 BLPB isolates were found in smokers, and 45 in nonsmokers (p < 0.05). One hundred twenty-five BLPB isolates were recovered from 91 patients (43%) with chronic sinusitis, including M catarrhalis, Bacteroides fragilis group, S aureus, H influenzae, Prevotella spp. and Fusobacterium spp; 69 BLPB isolates were found in smokers, and 56 in nonsmokers (p < 0.001). Antimicrobial therapy had been administered in the past month to 130 patients (28%; 60 smokers and 70 nonsmokers; p < 0.025). Both MRSA and BLPB were isolated more often from these individuals (p < 0.025). However, the higher isolation rates of MRSA and BLPB in smokers were independent of previous antimicrobial therapy. Conclusions: These data illustrate a greater frequency of isolation of S aureus, MRSA, and BLPB in patients with acute and chronic sinusitis who smoke.

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.

scholarly journals Bacterial flora in chronic sinusitis in children

New Medicine ◽  
2018 ◽  
Vol 22 (4) ◽  
Author(s):  
Michał Michalik ◽  
Adrianna Podbielska-Kubera ◽  
Maria Pawłowska ◽  
Jolanta Miazga
Keyword(s):  
Bacterial Resistance ◽  
Chronic Sinusitis ◽  
Bacterial Flora ◽  
Anaerobic Bacteria ◽  
Paediatric Population ◽  
Diagnostic Value ◽  
Acute Sinusitis ◽  
Respiratory Pathogens ◽  
Bacterial Strains ◽  
Coagulase Negative Staphylococci

Chronic rhinosinusitis is one of the main causes of morbidity in the paediatric population. The aetiology of chronic sinusitis (CS) is still investigated. Most cases of chronic sinusitis develop from unresolved acute sinusitis. Acute sinusitis is usually associated with one species of bacteria (most often aerobic), whereas chronic sinusitis is dominated by a mixed bacterial flora including 2-3 bacterial strains. The most common pathogens in chronic sinusitis are S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus, coagulase-negative staphylococci, as well as Gram-negative bacteria, such as Pseudomonas aeruginosa, Proteus spp., Klebsiella spp., Enterobacter spp., Escherichia coli and anaerobic bacteria. Staphylococci predominated in the study group of patients: 36 strains of S. aureus and 31 strains of S. epidermidis were isolated. Typical respiratory pathogens were practically absent, and constituted only a small percentage of all isolated microorganisms. Full diagnosis and treatment of patients with chronic sinusitis should include laryngological, microbiological, allergological, biochemical, and histopathological consultations as well as diagnostic imaging. Isolation of materials with high diagnostic value (aspirates, tissues) is very important. The selection of appropriate antibiotic therapy, in addition to assessing bacterial resistance to antibiotics, may require the determination of virulence traits of cultured strains.

OCCURRENCE OF THE RISKS FOR DEVELOPMENT OF RESPIRATORY DISEASES IN CHILDREN EXPOSED TO THE CHEMICAL FACTORS OF THE EXPOSURE OF ALUMINA REFINERY- ASSOCIATED BUSINESS ACTIVITY

2019 ◽  
pp. 42-47 ◽  
Author(s):  
M.A. Zemlianova ◽  
I.V. Tikhonova
Keyword(s):  
Respiratory Tract ◽  
Respiratory Diseases ◽  
Inflammatory Diseases ◽  
Allergic Inflammation ◽  
Respiratory Morbidity ◽  
Upper Respiratory Tract ◽  
Negative Effects ◽  
Wide Range ◽  
Chemical Factors ◽  
Chronic Lymphoproliferative Diseases

Alumina refineries are among the leading sources of atmospheric air pollution with a wide range of pollutants hazardous to human respiratory organs. It is relevant to study and evaluate the occurrence of the risks for development of respiratory diseases in children living in the area affected by the emission components of an alumina refinery. We assessed air quality of the area under observation and comparison according to monitoring observations, risk of non-carcinogenic effects from the respiratory organs. The content of chemicals in the blood and urine adequate to risk factors was quantified. The structure of individual groups of respiratory diseases was analyzed. The causal relationships of violations of laboratory parameters with an increased content of chemicals in biological media were evaluated. It was found that an aerogenic exposure of chemical pollutants is formed on the territory with the production of metallurgical alumina. It determines the risk for development of respiratory diseases, exceeding an acceptable level up to 49.9 times. In the exposed children, the content of manganese, chromium, nickel, copper, xylenes, formaldehyde and aluminum, fluoride ion in the urine was increased to 4.2 times in relation to the indices in the comparison group. A high level of additional respiratory morbidity(1.8 times) was revealed. Chronic lymphoproliferative diseases of the nasopharynx and inflammatory diseases of the upper respiratory tract (up to 6.6 times more often), inflammatory diseases with a predominance of the mechanism of allergic inflammation ( up to 2.1 times more often)are more often detected in the framework of the respiratory diseases. Negative effects on the part of the respiratory system in the form of activation of antioxidant processes, the development of an inflammatory reaction, local, general and specific sensitization of the respiratory tract were established. It confirms the occurrence of the risks for the development of respiratory diseases in children in the exposure area of the chemical factors of alumina refinery-associated economic activity.

scholarly journals Dose-dependent response to infection with SARS-CoV-2 in the ferret model and evidence of protective immunity

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kathryn A. Ryan ◽  
Kevin R. Bewley ◽  
Susan A. Fotheringham ◽  
Gillian S. Slack ◽  
Phillip Brown ◽  
...  
Keyword(s):  
Protective Immunity ◽  
Viral Rna ◽  
Dose Titration ◽  
High Dose ◽  
Lung Pathology ◽  
Upper Respiratory Tract ◽  
Virus Shedding ◽  
Upper Respiratory ◽  
Dose Dependent ◽  
Titration Study

AbstractThere is a vital need for authentic COVID-19 animal models to enable the pre-clinical evaluation of candidate vaccines and therapeutics. Here we report a dose titration study of SARS-CoV-2 in the ferret model. After a high (5 × 106 pfu) and medium (5 × 104 pfu) dose of virus is delivered, intranasally, viral RNA shedding in the upper respiratory tract (URT) is observed in 6/6 animals, however, only 1/6 ferrets show similar signs after low dose (5 × 102 pfu) challenge. Following sequential culls pathological signs of mild multifocal bronchopneumonia in approximately 5–15% of the lung is seen on day 3, in high and medium dosed groups. Ferrets re-challenged, after virus shedding ceased, are fully protected from acute lung pathology. The endpoints of URT viral RNA replication & distinct lung pathology are observed most consistently in the high dose group. This ferret model of SARS-CoV-2 infection presents a mild clinical disease.

Effects of antibiotics on the development and intestinal bacterial diversity of black soldier fly larvae

2021 ◽  
pp. 1-14
Author(s):  
J.B. Zhang ◽  
Y. Meng ◽  
J. Xu ◽  
C. Rensing ◽  
D. Wang
Keyword(s):  
Bacterial Diversity ◽  
Larval Growth ◽  
Anaerobic Bacteria ◽  
Inhibitory Effect ◽  
High Dose ◽  
Streptomycin Sulphate ◽  
Black Soldier Fly ◽  
Operational Taxonomic Units ◽  
Black Soldier Fly Larvae ◽  
Hermetia Illucens Larvae

The effects of four antibiotics (metronidazole (M) levofloxacin (L), sodium ampicillin (A), and streptomycin sulphate (S)) and their pair-wise combinations at three doses on the development and intestinal bacterial diversity of the black soldier fly (BSF; Hermetia illucens) larvae were studied. At a low dose M and L were able to inhibit larval growth. At a high dose, all antibiotics were shown to inhibit larval growth. However, the pair-wise combinational use of the antibiotics did not effectively enhance the inhibitory effect. The gut bacterial diversity of the normal control (NC) was significantly higher than the antibiotic-treated groups with 737 operational taxonomic units (OTUs) from the larval guts of NC, compared to 305 and 227 from ML and AS. The number of anaerobic bacteria in ML was significantly lower than in NC and AS, with the relative abundance of OTUs from larval guts of ML being only about 0.01, compared to 0.4 for NC and 0.15 for AS. These results indicated that antibiotics at the experimental concentration did not affect the palatability of food for insects, but they would affect the diversity of food and intestinal microorganisms of BSF larvae, and the inhibitory effect of antibiotics on growth and development of BSF larvae displayed in this study was a complex effect.

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