Objectives: To examine the yield and resistance profile of pathogens in chronic rhinosinusitis (CRS) patients receiving culture-directed management and to pay particular attention to the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in this population.
Study Design: Retrospective review of a CRS microbiology database.
Participants: Consecutive CRS patients seen at the St. Paul's Sinus Centre between June 2007 and August 2008.
Setting: Canadian tertiary sinus centre.
Main Outcome Measure: To determine the pathogens isolated, the frequency of these pathogens, and their resistance profiles.
Results: The most common bacterial pathogens isolated were Staphylococcus aureus, accounting for 39% of cultured samples, followed by Haemophilus influenzae (29%), Pseudomonas aeruginosa (15%), Streptococcus pneumoniae (12%), and Moraxella catarrhalis (11%). Only three cases of MRSA were found, one in a patient with cystic fibrosis.
Conclusion: MRSA does not appear to pose a significant risk of morbidity in our patient population. However, ongoing concern regarding the increasing prevalence of S. aureus and antimicrobial resistance in chronic sinonasal disease highlights the importance of using culture-directed antimicrobial therapy with the goal of minimizing future resistance patterns.
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