A Changing Pattern of Bacterial Flora In Empyema of the Maxillary Sinus

Abstract

The bacterial flora of empyema of the maxillary sinuses in 100 patients were studied. Patients' age ranged from 15 to 58 : 65 were males and 35 were females. Aseptic collection of the pus material from only one of the maxillary sinuses was made when the patients were under local anesthesia for Caldwell-Luc operation. All samples were cultured for both aerobes and anaerobes. At least one type of organism was isolated in 96 patients and in the remaining 4, no bacterial growth was obtained after 2 weeks of cultivation. Aerobes were isolated in 76 patients, either alone (52), or mixed with other aerobe(s) (15) or anaerobe(s) (9). Anaerobes were isolated in 29 patients, either alone (13), or mixed with other anaerobe (7). There were 95 aerobic isolates and the predominant ones were: 31 coagulase-negative Staphylococci (24.6%), 28 Streptococcus viridans (22.2%), and 5 Corynebacterium species (4.0%). There were 31 anaerobic isolates and the predominant ones were: 6 Propionibacterium acnes (4.8%), and 4 each of Bacteroides species, Peptococcus species, Bacillus corrodens, Streptococcus intermedius (3.2% each). The presence of aerobic and anaerobic organisms in empyema of the maxillary sinus suggested that anaerobic organisms could playa significant role in its pathogenesis. There appears to be a changing trend in the bacterial flora of chronically inflamed paranasal sinuses. It is plausible that this change may have been brought by the increased awareness of significance of anaerobic bacteria, better methods of cultivation, and the emergence of resistant strains to conventional antimicrobial agents.