ENDOSCOPICALLY GUIDED CULTURES IN CHRONIC SINUSITIS

In chronic sinusitis, culture-directed antibiotics are often recommend ed as a cornerstone of treatment The significance of Gram-negative rod s (GNRs), coagulase-negative Staphylococci (SCN), and Staphylococcus a ureus has been controversial. In an effort to determine host factors w hich correlate with culture results, 507 endoscopically-guided culture s are reviewed from 265 patients. A history of asthma, allergic rhinit is, prior sinus surgery, and the concurrent use of antibiotics, steroi ds, and irrigations were some of the host factors compared by X-2. The results were compared to a control group of 50 cultures from healthy volunteers. SCN, S, aureus, P. aeruginosa, and Streptococcus were the most common isolates. GNRs were present in 27% of cultures and were mo re common in patients who had prior sinus surgery or were using irriga tions. P. aeruginosa was more common in patients taking systemic stero ids. SCN occurred with the same incidence in patients and control subj ects but was more prevalent in cultures obtained intraoperatively and in patients taking systemic steroids. No identifiable host factor was associated with S. aureus. S. aureus occurred at similar rates in pati ents and control subjects but grew heavily in patients and exhibited o nly light growth in controls. Topical nasal steroids appear to have no statistically significant effect on bacterial cultures. Findings from this study further our understanding of chronic sinusitis and may hel p guide practitioners in the treatment of this disease.