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Odontogenic and rhinogenic chronic sinusitis: a modern microbiological comparison
Author(s) -
Saibene Alberto Maria,
Vassena Christian,
Pipolo Carlotta,
Trimboli Mariele,
Vecchi Elena,
Felisati Giovanni,
Drago Lorenzo
Publication year - 2016
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21629
Subject(s) - medicine , sinusitis , nasal polyps , antibiotics , sinus (botany) , teicoplanin , amoxicillin , vancomycin , surgery , microbiology and biotechnology , staphylococcus aureus , bacteria , botany , genetics , biology , genus
Background Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) play a relevant, often underappreciated role in paranasal sinus infections. Treating SCDDT patients requires tailored medical and surgical approaches in order to achieve acceptable success rates. These approaches differ from common rhinogenic sinusitis treatment protocols mostly because of the different etiopathogenesis. Our study comprehensively evaluated microbiology and antibiotic resistance in SCDDT patients and compared findings with a control group of patients affected by rhinogenic sinusitis. Methods We performed microbiological sampling during surgery on 28 patients with SCDDT and 16 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Colonies were isolated, Gram‐stained, and the species identified using classic biochemical methods. These results were confirmed by DNA pyrosequencing, and then the resistance profile of each SCDDT isolate to various antibiotics was tested. Results Microbial growth was observed in all SCDDT patients, whereas samples from 60% of patients in the control group failed to yield any bacterial growth ( p < 0.001). Anaerobes grew in 14% of SCDDT patients as compared to 7% of CRSwNP patients ( p = 0.42). Of the isolates from SCDDT patients, 70% were susceptible to amoxicillin/clavulanate, whereas all isolates were susceptible to levofloxacin, teicoplanin, and vancomycin. Of the staphylococci identified, 80% were capable of producing beta‐lactamase. Conclusion Given the extent of microbiological contamination within the maxillary sinus of SCDDT patients, these infections should be regarded as a different class of conditions from rhinogenic sinusitis. Our findings support the need for different approaches in the treatment of SCDDT patients.