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Braz J Infect Dis. 2014 Mar-Apr;18(2):215-9. doi: 10.1016/j.bjid.2013.07.006. Epub 2013 Nov 22.

Microbiology of the middle meatus compared to sputum in young patients with cystic fibrosis from Bahia - Brazil.

Author information

1
Postgraduate Course in Medicine and Human Health of Bahian School of Medicine and Public Health, Salvador, BA, Brazil; Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil. Electronic address: alessandrotunesb@gmail.com.
2
Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil; Oswaldo Cruz Foundation, Salvador, BA, Brazil. Electronic address: joice@ufba.br.
3
Postgraduate Course in Medicine and Human Health of Bahian School of Medicine and Public Health, Salvador, BA, Brazil; Pediatric Pulmonary Clinic of Bahia Reference Center for Cystic Fibrosis, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: reginaterse@gmail.com.
4
Pediatric Pulmonary Clinic of Bahia Reference Center for Cystic Fibrosis, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: angelicasantana@terra.com.br.
5
Pediatric Pulmonary Clinic of Bahia Reference Center for Cystic Fibrosis, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: heom@saude.ba.gov.br.
6
Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil. Electronic address: tfbarros@uol.com.br.
7
Microbiological Laboratory, School of Pharmacy, Federal University of Bahia, Salvador, BA, Brazil. Electronic address: aksleal@gmail.com.
8
Microbiological Laboratory, Octávio Mangabeira Hospital, Salvador, BA, Brazil. Electronic address: heom@saude.ba.gov.br.
9
Postgraduate Course in Medicine and Human Health of Bahian School of Medicine and Public Health, Salvador, BA, Brazil; Oswaldo Cruz Foundation, Salvador, BA, Brazil. Electronic address: grassi@bahia.fiocruz.br.

Abstract

Lower airway infection is a major cause of morbidity and mortality in patients with cystic fibrosis. It is currently unknown if the infection of the upper airway can cause exacerbation of lower respiratory tract infection. This study aimed to determine the microbiological profile of the anterior paranasal sinuses outflow tract (middle meatus) of cystic fibrosis outpatients. The microbiological profile was defined using endoscopically directed middle meatal cultures. Paired middle meatal and sputum specimens were collected from 56 outpatients for aerobic cultures. A semi-quantitative leukocyte count of the middle meatal samples was performed. The median age of patients was nine years (3-20 years). Staphylococcus aureus (37%), Staphylococcus coagulase-negative (25%), Neisseriac (14%), Pseudomonas aeruginosa (11%), and Streptococcus pneumoniae (7%) were the most prevalent microorganisms in the middle meatal cultures. Using the middle meatal leukocyte count, 16 out of 54 patients (29.6%) presented sinus infection. The most frequently identified pathogens in patients with sinus infections were Staphylococcus aureus (10 patients), Pseudomonas aeruginosa (4 patients), and Streptococcus pneumoniae (3 patients). Agreement of paired middle meatal and sputum cultures was significantly higher among patients with infection in middle meatal (69%). The most common middle meatal pathogens were the typical cystic fibrosis spectrum. This suggests the potential for participating in post-nasal lower airway seeding.

KEYWORDS:

Cystic fibrosis; Endoscopy; Infection; Middle meatus

PMID:
24275368
DOI:
10.1016/j.bjid.2013.07.006
[Indexed for MEDLINE]
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