Bacteriological Study of Chronic Maxillary Sinusitis--- Journal

8/6/2019 Bacteriological Study of Chronic Maxillary Sinusitis--- Journal

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Moderator: Dr. N.JANARDHAN

Presenter: Dr.R.RAGHAVENDRA REDDY


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The microbiology of chronic maxillarysinusitis is polymicrobial, consisting of

both aerobic and anaerobic bacteria. Chronic sinusitis is suspected of being

caused by impaired paranasal sinus

ventilation and drainage disorders. Several studies have shown that in the

majority of cases of chronic sinusitis,bacterial culters are negative.


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Even PCR techniques have failed todemonstrate bacterial infection in most

of cases. However none of these techniques

employed adequate methods for the

recovery of anaerobic bacteria. This study is aimed to summarize their

experience in recovery of microorganisms in adults.


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Judging the presence of sinusitis:waters view or lateral view or CT scan

nose and paranasal sinuses taken.mucosal thickening, air fluid level, orcomplete opacification of maxillarysinus is taken as criteria.

mucosal thickening was evaluated bynoting the nearest distance b/w the air mucosal interface and the lateral part ofthe sinus wall.


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mucosal thickening was defined as amucosal width of 5mm or more.

patients had atleast one of the followingcomplaints facial pain, head ache,purulent nasal discharge, fever or

malaise.chronic sinusitis was defined based onthe clinical records as an infection ofatleast 12 weeks duration.


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Collection and transport of specimen:specimens are collected using sinus

puncture through the inferior meatus orby the middle meatal antrostomy whiledoing endoscopic sinus surgery.specimens were transported to the

laboratory in a thioglycollate broth.the time b/w the collection andinoculation of the specimen did notexceed 30 minutes.


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Inoculation of specimens:specimens were inoculated on to 5% sheeps blood, chacolate and

Mac-conkeys agar plates for aerobic and facultative organisms.The plates were incubated at 37degree.C. aerobically (Mc conkey)or under 5% co2 (5% sheep and chacolate agars) and examined at24 and 48 hours.

For anaerobes the material is pasted on to prereduced vit.K1-enriched Brucella blood agar, an anaerobic blood agar platecontaining Kanamycin and Vancomycin hydrochloride ananaerobic blood plate containing Colistin sulfate andNalidixicacid. The anaerobic plates are incubated in jars (gaspak) and

examined at 48 and 96 hours.Aerobic and anaerobic bacteria were identified usingconventional techniques.Antibiotic sensitivity testing was done by Kirby Bauer diskdiffusion method using standard antibiotic disks on allaerobic/facultative organisms.


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Bacteriological Study of Chronic Maxillary Sinusitis--- Journal

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