Fevzi Sefa DEREKÖY, Davut AKTAŞ, Ahmet BÜYÜKBAŞUSTA, Mustafa ÖZYURT

Bacteriology of antrum in chronic maxillary sinusitis

Kronik sinüzitin mikrobiyal etyolojisi hakkında pek çok araştırma vardır ve bunların arasında da derin farklar göze çarpmaktadır. Günlük hayatta sinüzit tanısı alan hastaların tedavisinin planlanmasında kültür ve antibiyogram testlerinin yapılması pratik değildir. Bu nedenle de antibiyotik seçimi ampirik olarak yapılmaktadır. Bu gerçekten hareketle, bu tür hastaların kültür ve antibiyogramları daha güvenilir metodlarla yapılmalı ve sık olarak ortaya konmalıdır. Bu çalışmada histopatolojik olarak doğrulanmış kronik maksiller sinüziti! hastalardan yirmibeş sinüs kültürü elde edildi. Bu hastalara, nares bölgesi ve nazal kaviteleri povidon iyodür solüsyonuyla silindikten sonra intranazal inframeatal antrostomi uygulandı. Maksiller sinüsten alınan kültür örnekleri aerobik ve anaerobik kültürler için farklı transport besi yerlerine ekildi. Ayrıca patolojik tanı için sinüs mukozasından biyopsi yapıldı. Mikroorganizma türlerinin tespiti sonrasında antibiyogram çalışmalarına geçildi. Olguların onyedisinde aerobik bakteriler bulunurken(%68), onbeşinde de anaeroplar izole edildi(%60). Yirmibeş hastanın yedisinde mikst enfeksiyon söz konusuydu. En sık rastlanılan bakteriler ise anaerobik streptokoklar, Stafilokokkus aureus, Hemofilus enfluenza, alfa-hemolitik streptokoklar ve bakteroid türleridir. Anibiyogramda en etkin grubun aminoglikozidler olması dikkat çekiciydi.

Kronik maksiller sinüzitiste antrum mikrobiyolojisi

There have been many investigations about the microbial aetiology of chronic sinusitis with great variations. Because the culture and the antibiogram tests in the management of the patients with sinusitis are impractical in daily life, selection of antibiotic drugs is done empirically. Keeping this fact in mind, the results of these tests should be disclosed more often on a reliable method. In this study, twenty-five sinus cultures were obtained from the patients with chronic maxillary sinusitis with pathological verification After treating the nares and inferior meatus with povidone iodine solution, intranasal inframeatal antrostomy was performed. Separate transport mediums specially prepared for aerobic and anaerobic collections were used. Following differentiation of the microorganisms, antibiotic sensitivity tests were determined. Biopsy specimens of maxillary sinus mucosa, obtained peroperatively were studied under the light microscope. Aerobic bacteria were recovered in seventeen cases(68%), whereas there were fifteen anaerobes isolated(60%). Mixed infections were seen in seven patients. The most common isolates were anaerobic streptococci, Staphylococcus aureus, Haemophilus influenzae, alpha-haemolytic streptococci and bacteroid species. It was noticed that the aminoglycoside antibiotics were the most effective drugs in tests.

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