BACTERIOLOGY AND BETA-LACTAMASE ACTIVITY IN ACUTE AND CHRONIC MAXILLARY SINUSITIS

Objective: To assess the bacteriology and beta-lactamase enzyme activi ty in aspirates of 10 acutely and 13 chronically inflamed maxillary si nuses. Results: The predominant organisms isolated in acute sinusitis were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella c atarrhalis, and those found in chronic sinusitis were Prevotella speci es, Fusobacterium species, and Peptostreptococcus species. Four P-lact amase-producing organisms (BLPOs) were isolated in four specimens (40% ) obtained from acutely inflamed sinuses, and 14 BLPOs were recovered from 10 chronically inflamed sinuses (77%). The predominant BLPOs in a cute sinusitis were H influenzae, and M catarrhalis; those in chronic sinusitis were Staphylococcus aureus, Prevotella species, Fusobacteriu m species, and Bacteroides fragilis. Conclusions: beta-Lactamase activ ity was detected in 12 (three in acute and nine in chronic sinusitis) of the 14 aspirates that contained BLPOs. The detection of beta-lactam ase activity in sinus aspirates provides support for the role of BLPOs in the failure of penicillin therapy in sinusitis.