The Etiology of Acute Bacterial Sinusitis. Results of SSSR Multicenter Microbiological Study | CMAC

The Etiology of Acute Bacterial Sinusitis. Results of SSSR Multicenter Microbiological Study

Clinical Microbiology and Antimicrobial Chemotherapy. 2005; 7(4):337-349

​ Stratchounski L.S., Tarasov A.A., Kryukov A.I., Sedinkin A.A., Aleksanyan T.A., Yanov Yu.K., Sergeev D.V., Krechikova O.I., Sukhorukova M.V., Edelstein I.A.
sinusitis S. pneumoniae H. influenzae antimicrobial resistance antimicrobial chemotherapy
Section
Antimicrobial Resistance
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2005; 7(4):337-349

Materials and Methods.

The aim of the study was to determine the structure of bacterial pathogens and their antimicrobial resistance in adult patients with acute maxillary sinusitis. A total of 311 strains isolated from 442 adult patients with acute maxillary sinusitis were included in the study during 2000–2003.

Results.

Clinically significant bacterial pathogens were isolated in 65.4% of patients; among them single microorganism were found in 87.3% of cases, >2 – in 12.7%. S. pneumoniae и H. influenzae were the most frequent isolates (47.0 and 23.8% of all strains, respectively). Third most frequent group of pathogens (12.9%) were non-group A β-hemolytic streptococci. Among 142 strains of S. pneumoniae no resistance to amoxicillin, amoxicillin/clavulanate, cefotaxime and cefepime was found; 4.2% of strains were intermediately resistant to penicillin. The only 1.4% of pneumococci were non-susceptible to macrolides. All S. pneumoniae strains were susceptible to levofloxacin and moxifloxacin. Among 67 strains of H. influenzae no resistance to cefuroxime was detected; rates of non-susceptibility to amoxicillin/clavulanate, cefotaxime and cefepime were 9.0%, 1.5%, 1.5% and 3.0%, respectively. Azithromycin and clarithromycin remain active against 98.5% and 92.5% strains of H. influenzae, respectively; no resistance to fluoroquinolones has been found.

Conclusions.

Aminopenicillins, 3rd generation cephalosporins, respiratory fluoroquinolones and macrolides can be considered as the drugs for empiric therapy of acute sinusitis in adults. At the same time the use of tetracyclines and co-trimoxazole should be avoided because of high rates of resistance.

  • 1. Peters E., Crater S., Phillips C.D., et al. Sinusitis and acute asthma in adults. Int Arch Allergy Immunol 1999; 118:372-4.
  • 2. Popa V., Nagy S.M. Immediate hypersensitivity in adults with IgG deficiency and recurrent respiratory infections. Ann Allergy Asthma Immunol 1999; 82:567-73.
  • 3. Gwaltney J.M., Scheld W.M., Sande M.A., et al. The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. J Allergy Clin Immunol 1992; 90:457-61.
  • 4. Penttila M., Savolainen S., Kiukaanniemi H., et al. Bacterial findings in acute maxillary sinusitis – European study. Acta Otolaryngol Suppl 1997; 529:165-8.
  • 5. Карпов О.И., Рябкова М.А., Карпищенко С.А. и др. Сравнительное исследование эффективности лечения острого синусита азитромицином (3-дневный курс) и ко-амоксиклавом (10-дневный курс). Тер архив 1998; (5):72-6.
  • 6. Пескова Ю.Ю. Клиническое исследование препарата амоксиклав у детей с синуситами. Новости отоларингологии и логопатологии 2000; (1):75-6.
  • 7. Bandak S.I., Turnak M.R., Allen B.S., et al. Antibiotic susceptibilities among recent clinical isolates of Haemophilus influenzae and Moraxella catarrhalis from fifteen countries. Eur J Clin Microbiol Infect Dis 2001; 20:55-60.
  • 8. Jacobs M.R., Felmingham D., Appelbaum P.C., et al. The Alexander Project 1998-2000: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents. J Antimicrob Chemother 2003; 52:229-46.
  • 9. Vanhoof R., Carpentier M., Cartuyvels R., et al. Surveillance of antibiotic resistance in clinical isolates of Streptococcus pneumoniae collected in Belgium during winter 2000-2001. Acta Clin Belg 2003; 58:111-9.
  • 10. Appelbaum P.C. Resistance among Streptococcus pneumoniae: Implication for Drug Selection. Clin Infect Dis 2002; 34:1613-20.
  • 11. Chin N., Della-Latta P., Whitter S., et al. In vitro activity of clarithromycin and 14-hydroxy clarithromycin versus H. influenzae and Group B Streptococcus in New York Area. Proceedings of the 2nd International Conference on the macrolides, azalides, and streptogramins; Venice, Italy; 1994.
  • 12. McCaig L.F., Hughes J.M. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA 1995; 273:214-9.
  • 13. Sinus and Allergy Health Partnership. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg 2000; 123 (1 Pt 2):1-31.
  • 14. American Academy of Pediatrics. Clinical practice guideline: management of sinusitis. Pediatrics 2001; 108:798-808.
  • 15. Brook I., Gooch III W.M., Jenkins S.G., et al. Medical management of acute bacterial sinusitis. Ann Otol Rhinol Laryngol 2000; 109 (Suppl.):1-20.
  • 16. Gehanno P., Berche P. Sparfloxacin versus cefuroxime axetil in the treatment of acute purulent sinusitis. J Antimicrob Chemother 1996; 37 (Suppl. A):105-14.
  • 17. Gwaltney J. Acute community-acquired sinusitis. Clin Infect Dis 1996; 23:1209-25.
  • 18. Felmingham D., Reinert R.R., Hirakata Y., et al. Increasing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveillance study, and comparative in vitro activity of the ketolide, telithromycin. J Antimicrob Chemother 2002; 50 (Suppl. S1):25-37.
  • 19. Burry A., Fuchs P., Pfaller M. Susceptibility of beta-lactam ase-producting and non-producting ampicillin-resistance strains of Haemophilus influenzae to ceftibuten, cefaclor, cefuroxime, cefixime and amoxicillin-clavulanic acid. Antimicrob Agents Chemother 1993; 37:14-8.
  • 20. Groot R., Dzoliic-Danilovic G., Kligeren B., et al. Antibiotic resistance in Haemophilus influenzae: mechanisms, clinical importance and consequences for therapy. Eur J Pediatr 1991; 150:534-46.
  • 21. Hoban D., Felmingham D. The PROTEKT surveillance study: antimicrobial susceptibility of Haemophilus influenzae and Moraxella catarrhalis form community-acquired respiratory tract infections. J Antimicrob Chemother 2002; 50 (Suppl. S1):49-59.
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