Professional paper

https://doi.org/10.20471/acc.2022.61.03.17

Microbial Causative Agents and their Antimicrobial Susceptibility Patterns in Chronic Rhinosinusitis – Impact on Antibiotic Prophylaxis and Treatment

Denis Ferenec orcid.org/0009-0000-3851-1453 ; Department of Othorinolaringology, County Hospital Čakovec, Čakovec, Croatia
Ana Gverić Grginić ; Department of Microbiology, Parasitology and Hospital Infections, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Carmen Prohaska Potočnik ; Department of Microbiology, Parasitology and Hospital Infections, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Katarina Kampić ; Department of Microbiology, Parasitology and Hospital Infections, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Marija Pastorčić Grgić orcid.org/0000-0002-3405-3675 ; University Hospital for Tumors, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia
Marko Velimir Grgić orcid.org/0000-0003-4196-5303 ; Department of Otorhinolaryngology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia

Abstract

Chronic rhinosinusitis (CRS) is debilitating condition comprising inflammation
of the mucosa of the nasal and paranasal sinuses, requiring conservative and often surgical treatment.
Functional endoscopic sinus surgery (FESS) is a CRS treatment during which a microbiological
diagnostic procedure may be conducted. Preoperative antibiotic prophylaxis is administrated
before FESS. When indicated, the administered empiric antibiotic therapy must cover most common
causing microbial agents. The aims of this study were to identify microbial pathogens isolated from
sinonasal cavities in patients undergoing endoscopic sinus surgery, to determine bacterial antibiotic
susceptibility patterns and compare them with guidelines for treatment and perioperative prophylactic
use of antimicrobial agents. A retrospective cohort study on 456 samples collected between 2016 and
2019 was conducted at the Department of Otorhinolaryngology, Head and Neck Surgery and the
Department of Microbiology, Parasitology and Hospital Infections in the Clinical University Centre
Sestre milordnice, Zagreb. The most common isolated pathogens were Peptostreptococcus spp., Propionibacterium
spp., Staphylococcus aureus, Pseudomonas spp., Fusobacterium spp. and Haemophilus
influenzae. According to antibiotic susceptibility patterns, empiric antibiotic treatment with amoxicillin-
clavulanic acid was appropriate. Due to high rates of antibiotic resistance of anaerobic bacterial
isolates to metronidazole, it cannot be recommended in empirical antibiotic treatment or preoperative
surgical antibiotic prophylaxis.

Keywords

Chronic Rhinosinutis; Sinus Endoscopic Surgery; Antibiotic Resistance; Antibiotic Prophylaxis

Hrčak ID:

296177

URI

https://hrcak.srce.hr/296177

Publication date:

1.11.2022.

Article data in other languages: croatian

Visits: 1.297 *