慢性鼻窦炎的细菌学研究

目的研究慢性鼻窦炎的细菌分布及其耐药性特征。方法术中收集76例慢性鼻窦炎患者上颌窦和后组筛窦的分泌物,分别进行需氧菌、厌氧菌与真菌的培养、药物敏感试验以及产β内酰胺酶菌株(βLPB)检测,同时以10名健康受试者作对照。结果实验组共培养出20种细菌,主要为表皮葡萄球菌、大肠埃希菌、金黄色葡萄球菌、甲型链球菌和肺炎链球菌等;细菌培养阳性率为81.8%,其中需氧菌占83.4%,厌氧菌占16.6%;革兰阳性菌为56.3%,革兰阴性菌43.7%;真菌培养阳性率仅1.4%。药物敏感试验显示对需氧菌抗菌活性较高的广谱抗生素是亚胺培南、头孢噻肟和阿莫西林克拉维酸;对厌氧菌抗菌活性较高的是甲硝唑、亚胺培南和氯霉素。βLPB检出率为37.7%,以表皮葡萄球菌、金黄色葡萄球菌、流感嗜血杆菌和卡他布兰汉菌的比例较高。对照组检测出表皮葡萄球菌和大肠埃希菌等5种细菌,与实验组同种细菌分布的差异无统计学意义(χ2=0.446,P>0.05)。结论慢性鼻窦炎以需氧菌感染为主,菌株耐药现象严重。细菌感染在本病中的作用并非关键,不宜过分强调抗生素的使用。应用抗生素治疗宜先进行细菌培养与药物敏感试验;如情况不允许,可选择广谱耐β内酰胺酶类抗生素,如头孢噻肟、阿莫西林克拉维酸等。     

208例慢性鼻窦炎患者中鼻道细菌学监测及药敏试验结果分析

目的研究慢性鼻窦炎患者的病原菌分布特征及其耐药性状。方法208例慢性鼻窦炎患者，鼻窦术前收集中鼻道分泌物，进行需氧菌培养、药物敏感试验及产β2内酰胺酶菌株（β2LPB）监测。结果共培养出17种细菌，主要为表皮葡萄球菌、大肠埃希菌等，培养阳性率为61．54％，其中革兰阳性菌占64．84％，革兰阴性菌为35．16％。药物敏感试验显示，对需氧菌抗菌活性较高的广谱抗生素有万古霉素、克林霉素、舒普深、碳青烯类。β2LPB检出率为61．38％。结论慢性鼻窦炎病程中的需氧菌感染以革兰氏阳性球菌为主，耐药现象严重。可考虑选用广谱耐β2内酰胺酶类抗生素。     

健康儿童与成人鼻腔中鼻道需氧菌分布的初步研究

目的:探讨健康儿童与成人鼻腔中鼻道细菌分布是否存在差异。方法:自健康儿童、青少年及成人鼻腔中鼻道取棉拭子标本进行需氧菌培养。结果:40例健康儿童鼻腔中鼻道培养出棒状杆菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、革兰阴性奈瑟菌、α-溶血性链球菌及革兰阴性杆菌6种细菌,细菌培养阳性率为80.0%;40例健康青少年及56例健康成人鼻腔中鼻道培养出棒状杆菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌3种细菌,其细菌培养阳性率分别为90.0%和92.9%。结论:健康儿童与成人及青少年鼻腔中鼻道细菌分布存在明显差异,健康青少年与成人鼻腔中鼻道细菌分布差异无统计学意义。     

53例慢性化脓性中耳炎患者分泌物细菌培养及药敏学分析

目的 分析53例慢性化脓性中耳炎患者分泌物细菌分布及药敏学的数据结果, 探讨此类患者的临床用药方案。方法 采用VITEK-2 COMPACT微生物分析系统对近3年住院的53例慢性化脓性中耳炎患者分泌物进行病原菌分离鉴定与药敏试验, 进行总结统计。结果 53份分泌物培养出微生物的有45份, 检出率为84.9%, 共培养出微生物49株, 其中革兰阳性球菌21株, 占42.9%;革兰阴性杆菌 21株, 占42.9%;真菌7株, 占14.2%。检出主要病原菌为铜绿假单胞菌, 占22.4%, 其次为表皮葡萄球菌、金黄色葡萄球菌, 分别占16.3%、14.3%。常见革兰阳性菌、革兰阴性菌对临床常用药物左氧氟沙星均有较高敏感性(分别为81.0%、90.9%)。结论 铜绿假单胞菌、表皮葡萄球菌、金黄色葡萄球菌是常见慢性化脓性中耳炎感染细菌, 对临床常用药物(如左氧氟沙星)有较高敏感性。而对常用药物治疗不敏感的病例要警惕细菌耐药可能, 及时行细菌培养, 真菌感染不容忽视。     

慢性鼻窦炎的需氧菌分析

目的分析慢性鼻窦炎的需氧菌分布及对常用抗生素敏感情况,为临床药物治疗慢性鼻窦炎提供依据。方法在鼻内镜手术中以无菌方式取215个慢性鼻窦炎的鼻窦内容物(实验组),进行需氧菌培养和常用抗生素的药敏试验,并与正常人群60例中鼻道分泌物(对照组)的细菌培养结果对比。结果实验组中检出单一细菌者占92%,2种细菌混合感染者占8%;对照组均检为单一细菌。实验组单菌感染的G 菌占54.7%,G-菌占45.3%;对照组G 菌占73.3%,G-菌占26.7%。蝶窦、筛窦以G 菌感染为主;额窦、上颌窦以G-菌感染为主。实验组需氧菌耐药情况严重。结论慢性鼻窦炎需氧菌感染以单一细菌为主,G 菌占大多数,但G-菌的肠道菌群感染比例较高。不同的鼻窦中需氧菌种类不同。慢性鼻窦炎需氧菌耐药性严重。临床围手术期应用抗生素治疗宜先进行细菌培养与药物敏感试验。     

鼻咽癌放疗后继发慢性鼻-鼻窦炎的细菌学检测

目的 通过研究鼻咽癌放疗后继发慢性鼻-鼻窦炎的细菌学特点,提高对该并发症的认识,并为临床诊治提供参考.方法 鼻咽癌放疗后继发慢性鼻-鼻窦炎患者30例,男24例,女6例,平均年龄42.7岁,平均病程2.9年.通过上颌窦穿刺术收集到上颌窦分泌物标本共37份,行需氧菌、兼性厌氧菌培养以及药敏试验.结果 阳性标本27份,共分离出32株细菌;革兰阳性球菌占62.5%,革兰阴性杆菌占31.3%.最常见细菌包括草绿色溶血性链球菌(18.75%)、流感嗜血杆菌(15.6%)和金黄色葡萄球菌(15.6%).头孢类及喹诺酮类抗生素的敏感性较高,而红霉素、克林霉素、复方新诺明以及青霉素的耐药率较高.结论 鼻咽癌放疗后继发慢性鼻-鼻窦炎的需氧或兼性厌氧菌分布以革兰阳性球菌为主.临床用药可有针对性地选择头孢类或喹诺酮类抗生素.     

伴和不伴鼻息肉的慢性鼻-鼻窦炎患者筛窦的细菌学研究

目的:比较伴和不伴鼻息肉的慢性鼻-鼻窦炎患者及正常对照患者前筛黏膜标本的细菌学特征.方法:在鼻内镜手术中获取前筛黏膜标本,进行需氧和厌氧培养.结果:送检前筛黏膜标本119例,经需氧和厌氧组织匀浆半定量细菌培养,104例标本细菌培养为阳性(细菌培养总阳性率为87.4%);其中慢性鼻-鼻窦炎不伴鼻息肉组(CRSNP-组)、慢性鼻-鼻窦炎伴鼻息肉组(CRSNP+组)、正常对照组需氧或兼性厌氧细菌培养阳性率分别为86.5%、85.7%、90.0%,3组比较差异无统计学意义(P>0.05).3组患者的黏膜标本以需氧菌和厌氧菌混合感染为主,混合感染率分别为CRSNP-组78.4%、CRSNP+组81.0%、对照组85.0%,差异无统计学意义(P>0.05).3组最常见需氧菌株为凝固酶阴性葡萄球菌、棒状杆菌属细菌,比较差异均无统计学意义(均P>0.05).厌氧菌培养阳性率3组分别为78.4%、76.2%、77.5%,差异无统计学意义(P>0.05);最常见厌氧菌株为丙酸杆菌属细菌、消化链球菌属细菌,差异均无统计学意义(均P>0.05).结论:CRSNP-组和CRSNP+组及对照组患者前筛黏膜标本的细菌学特征无明显差异,细菌感染并非是慢性鼻-鼻窦炎发生鼻息肉这一机制中的惟一因素.     

慢性鼻-鼻窦炎的细菌培养与药敏分析

目的　分析慢性鼻-鼻窦炎的细菌学特点与药敏试验结果,为临床治疗提供依据。方法　鼻内镜下采集中鼻道脓液进行细菌培养及药敏试验。结果　43例标本中,37例培养出细菌,细菌培养阳性率为86.04%;需氧菌株占91.90%,厌氧菌株占8.10%;共培养出20种细菌,主要为表皮葡萄球菌、铜绿假单胞菌、金黄色葡萄球菌。抗生素药 敏试验显示抗菌活性较高的广谱抗生素为头孢哌酮舒巴坦钠、头孢呋辛钠。结论　慢性鼻-鼻窦炎以需氧菌感染为主,应用抗生素宜先进行细菌培养和药敏试验,如情况不允许,可选择广谱的耐β-内酰胺酶类抗生素,如头孢哌酮舒巴坦钠、头孢呋辛钠等。     

慢性鼻-鼻窦炎患者细菌学检测及药敏分析

目的　探讨慢性鼻-鼻窦炎（CRS）患者细菌学分布及药敏分析。方法　63例确诊为CRS的手术患者,取中鼻道脓性分泌物行普通细菌培养,对有临床意义的细菌 行药敏试验。结果　63例患者中,43例普通细菌培养结果为阳性,阳性率为68.25%,共分离出细菌15种,排在前3位的是甲型链球菌/黄色奈瑟菌、金黄色葡萄球菌、表皮葡萄球菌。27株行药敏试验,排在前4位的抗生素是环丙沙星81.48%,复方新诺明66.67%,庆大霉素59.26%,左氧氟沙星51.85%。结论　对于CRS患者,应根据药敏结果选择抗生素,若未能行药敏试验,应首选喹诺酮类抗生素。     

呼吸内科住院患者下呼吸道感染的病原菌谱及耐药性观察

目的探究呼吸内科住院患者下呼吸道感染的病原菌谱及耐药性。方法随机抽取我院2015年1月~2016年1月收治的呼吸内科住院患者956例痰液标本进行检验,分析标本中病原菌的构成情况及其耐药性。结果 956例痰液标本中共分离出481例病原菌,检出率为50.3%。其中革兰阴性菌301株,占62.6%(301/481);革兰阳性菌120株,占24.9%(120/481);真菌60株,占12.5%(60/481)。在革兰阴性菌中,铜绿假单胞菌占比最高,占21.2%(102/481);革兰阳性菌中,肺炎链球菌的占比最高,占12.5%(60/481);真菌中白假丝酵母菌的占比最高,占6.6%(32/481)。革兰阴性菌中铜绿假单胞菌耐药性最严重的是氨苯西林(92.12%)、头孢曲松(79.63%)及头孢唑林(79.85%);肺炎克雷伯菌耐药最严重的是头孢曲松(88.25%)、头孢唑林(87.36%)、氨苯西林(85.69%)及头孢噻肟(79.25%);鲍曼不动杆菌耐药最严重的是头孢曲松(89.69%)、头孢噻肟(85.69%)及头孢唑林(84.62%)。革兰阳性菌中耐甲氧西林葡萄球菌耐药性最严重的是红霉素(100%)、阿莫西林克拉维酸(100%)及四环素(79.63%);金黄色葡萄球菌耐药性最严重的是红霉素(100%)、阿莫西林克拉维酸(100%)及四环素(91.63%);肺炎链球菌耐药性最严重的是红霉素(100%)、阿莫西林克拉维酸(98.63%)及四环素(93.63%).结论下呼吸道感染的患者,革兰阴性菌的占比最大,铜绿假单胞菌是主要的病原菌,致病菌对各种药物的耐药性各不相同,应该根据具体的药敏试验结果合理的使用抗菌药物。     

Maxillary sinuses microbiology from patients with chronic rhinosinusitis

There isn't definitive and consistent data concerning the distribution of bacterial species in patients with Chronic Sinusitis (CS). The variability of the results from studies in CS may be due to the different techniques used as collection method, variations in culture methods, previous antibiotic use, and difficulty in distinguishing bacterial flora from pathogenic agents.Study designClinical prospective.AimTo identify the incidence of microorganisms in patients with CRS by growing bacteria from the secretion of the maxillary sinus.Patients and MethodsCross-sectional study in 62 patients that had undergone FESS for treatment of chronic sinusitis; cultures from the maxillary sinus were obtained.Results62 samples, 33 (53.2%) had no growth; 29 (45.2%) counts of aerobic bacteria; one case (1.6%) of fungus growth; we did not find anaerobic bacteria. Pseudomonas aeruginosa was the one more frequently found - 8 samples (27.6%), Staphylococcus aureus and Staphylococcus epidermidis in 4 samples each; Streptococcus pneumoniae in 3 samples (10.4%); other Gram negative agents in 17 samples (31%).ConclusionIn the present study we concluded that Pseudomonas aeruginosa, other Gram negatives bacteria and Staphylococcus spp were the representatives of the bacterial flora found in the paranasal sinuses of patients with CS.     

Microbiology of acute exacerbation chronic sinusitis in adults

The bacterial flora taken by sinus puncture from 115 patients with uni and bilateral acute exacerbation of chronic maxillary sinusitis was analyzed. Germ-free culture was obtained in 49 cases (40%) and in 69 cases (60%) bacteria were isolated from all sinus aspirates. Microbiological evaluation shows, that in majority of cases (90%) of acute exacerbation of chronic sinusitis there were pathogenic bacteria namely aerobic and anaerobic. The most frequent pathogens isolated from the aspirates were; Staphylococcus aureus, Haemophilus influenzae, Escherichia coli, Streptococcus pneumoniae, Staphylococcus hominis, Propionibacterium acnes i Candida albicans. The culture analysis proves that one or more pathogens can be the etiological factor. In the majority of cases (64%) the sinusitis is caused by monoculture.     

Bacterial infection after endoscopic sinus surgery: a controlled prospective study

OBJECTIVES/HYPOTHESIS: The objective was to determine whether infections occurring after endoscopic sinus surgery represent overgrowth of sinonasal flora versus de novo bacterial infection. STUDY DESIGN: Prospective controlled cohort study. METHODS: A cohort of adult patients was prospectively followed after endoscopic sinus surgery. Baseline postoperative control cultures of the ethmoid sinus were obtained. Patients with acute infectious exacerbations of chronic rhinosinusitis had endoscopic culture, and these results were compared with baseline culture data. RESULTS: One hundred thirteen patients were followed for a mean period of 14.5 months after endoscopic sinus surgery. Baseline postoperative culture data revealed that the ethmoid labyrinth was sterile in 23% of cases, carried oral flora in 18% of cases, and was colonized in 60% of cases. Gram-positive cocci, particularly staphylococcal species, were the most common colonizing organisms (41% of cases). Twenty acute exacerbations were cultured in 17 patients during the follow-up period. All infectious cultures recovered bacteria; one culture recovered only oral flora. Gram-positive cocci predominated (56% of isolates) with Staphylococcus aureus being the most common isolate (28%). Of the 36 isolates, only 9 isolates (25%) corresponded to bacteria identified at the time of baseline culture. CONCLUSION: Although the postoperative sinonasal cavity may be colonized by bacteria after endoscopic sinus surgery, infections arising postoperatively most commonly represent de novo infections by bacteria other than colonizing bacteria. Empirical therapy based on baseline data may be misleading; acute exacerbations of chronic rhinosinusitis after endoscopic sinus surgery should be cultured to guide optimal antibiotic therapy.     

Bacteriologic evaluation of middle ear fluid during the course of secretory otitis media in children

Fluid collected from tympanic cavity during operation from 43 children with O.M.S. was subjected to bacteriological examination. After the collection, each sample was immediately applied to Bactec Peds Plus/F liquid medium from Becton Dickinson. The number of samples, where each genus and species of bacteria were found, was determined, as well as the number of samples where every two genus coexisted; also the pH genes, in which each genus was found were calculated. Obtained results showed that 22 species of bacteria, belonging to 6 genus lived in the samples. The most commonly occurring genus were Staphylococcus, Streptococcus and Haemophilus; the most rare genus were Moraxella and Bacillus. The most common species were: Haemophilus influenzae (18.6% of samples), Staphylococcus aureus (14.0%), Staphylococcus epidermidis (11.6%), Staphylococcus warneri (9.3%) and Streptococcus oralis (7.0%). Streptococcus coexisted most frequently with Staphylococcus and Haemophilus; Staphylococcus--with Haemophilus and Bacillus; Haemophilus--with Streptococcus and Staphylococcus. The pH ranges for the three most often found genus were: for Staphylococcus--7.7-9, for Streptococcus--7.7-9.3 and for Haemophilus--8.2-8.8.     

Bacteriologic findings in patients with chronic sinusitis

We studied the bacteriology of maxillary sinus aspirates obtained from patients diagnosed with chronic sinusitis. We recovered 659 strains from 510 aspirates; of these, 572 (86.8%) were aerobes and 87 (13.2%) were anaerobes. Aerobes only were recovered from 310 of the 510 specimens (60.8%) and anaerobes only from 31 (6.1%). Among the 572 aerobic bacteria, the most prevalent organisms were Streptococcus viridans (158 strains [27.6%]), Streptococcus pneumoniae (67 [11.7%]), Corynebacterium species (66 [11.5%]), Staphylococcus aureus (54 [9.4%]), Moraxella catarrhalis (38 [6.6%]), Hemophilus parainfluenzae (33 [5.8%]), and group C beta-hemolytic streptococci (26 [4.5%]). Among the 87 recovered anaerobes were species of Peptostreptococcus (32 strains [36.8%]), Prevotella (22 [25.3%]), Actinomyces (13 [14.9%]), Propionibacterium (11 [12.6%]), Fusobacterium (8 [9.2%]), and Veillonella (1 [1.1%]). Beta-lactamase production was detected in 115 of the 572 aerobic strains (20.1%) and in 10 of the 87 anaerobic strains (11.5%). We found that the prevalence and type of organisms we identified in chronic sinusitis did not differ substantially from those reported in previous studies. Our study is one of the more extensive reports on the type and prevalence of pathogens in chronic sinusitis that has been published to date.     

Bacterial infection in chronic rhinosinusitis: a controlled paired analysis

BACKGROUND: The aim of this study was to determine if pathogenic bacteria are involved in the pathogenesis of chronic rhinosinusitis (CRS). METHODS: A consecutive series of adult patients with unilateral sinus disease determined by unilateral radiographic involvement or unilateral purulent secretions was microbiologically studied. Aerobic and anaerobic bacterial and fungal cultures were obtained during endoscopic sinus surgery from purulent secretions or tissue culture. Positive culture rates were compared between the diseased sinus and the contralateral nondiseased (control) sinus to determine if pathogenic bacteria were more commonly recovered from the diseased sinuses. RESULTS: Forty-nine adult patients completed the study with appropriate microbiological data. Coagulase-negative staphylococci were the most commonly recovered bacteria followed by Staphylococcus aureus from the diseased side of the sinuses with similar findings for the control sinus. Bacterial species were recovered from 87.8% of the diseased side of the sinuses versus 85.7% from the control sinuses (p = 0.50). Reanalysis with coagulase-negative staphylococci considered as nonpathogen showed a 46.9 and 49.0% positive bacterial culture rate in diseased and control groups, respectively (p = 0.50). No significant difference in positive anaerobic culture rates were identified between groups (59.1% diseased versus 55.1% control, respectively, p = 0.61). Antibiotic resistance rates were no different between bacteria cultured from diseased sinuses versus control (p = 0.115). CONCLUSION: Both aerobic and anaerobic bacterial species may be recovered from both diseased and nondiseased sinuses in patients with CRS. These findings cast some doubt on the exact etiologic role of bacteria in CRS, suggesting other factors or other agents also may be responsible in CRS pathogenesis.     

慢性鼻-鼻窦炎患者窦腔的细菌分布及药敏观察研究

目的探究慢性鼻-鼻窦炎患者窦腔的细菌分布及药敏结果,旨意为相关人员的研究工作提供参考文献。方法本试验择取2018年10月26日-2019年10月26日我院内耳鼻喉头颈外科内收治的102例慢性鼻-鼻窦炎患者为研究样本。对其开展窦腔的细菌分布及药敏实验,分析结果。结果送检样本共计102例,阳性82例。其中诸如金黄色葡萄球菌等等菌株各2株;粪肠球菌、产气肠杆菌、铜绿假单胞菌、烟曲菌各4株;克氏库克菌6株;表皮葡萄球菌34株。就分离菌株针对于常用抗生素敏感度:青霉素为8.3%、头孢呋辛钠为30.4%、头孢曲松钠为39.4%、氨苄西林/舒巴坦为35.9%、克拉霉素为45.0%、阿奇霉素为47.6%、复方新诺明为67.7%、环丙沙星为81.6%、利福平为90.9%、左旋氧氟沙星为92.3%、莫西沙星以及万古霉素均为100.0%。结论慢性鼻鼻窦炎患者大都存在细菌感染的情况。此类患者在接受完毕内镜鼻窦手术之后,可以优先考虑使用喹诺酮类药物治疗疾病。     

Microbiology and management of acute suppurative thyroiditis in children

This review describes the microbiology, diagnosis and management of suppurative thyroiditis (ST). Staphylococcus aureus, Streptococcus pyogenes, Streptococcus epidermidis, and Streptococcus pneumoniae, are the predominant aerobic isolates. The most common anaerobic bacteria are Gram-negative bacilli and Peptostreptococcus spp. Agents that are rarely recovered include Klebsiella spp., Haemophilus influenzae, Streptococcus viridans, Salmonella spp., Enterobacteriaceae, Mycobacterium tuberculosis, atypical mycobacteria, Aspergillus spp., Coccidioides immitis, Candida spp., Treponema pallidum, and Echinococcus spp. Viruses have been associated with subacute thyroiditis, and include measles, mumps, influenza, enterovirus Epstein-barr, adenovirus, echovirus, and St Louis encephalitis. Therapy includes administration of antibiotics effective against the causative pathogen(s). Proper selection of therapy can be guided by culture of the lesion. Surgical drainage may be necessary in case of suppuration.     

Microbiology of middle meatus in chronic rhinosinusitis

BACKGROUND: Nasal endoscopy allows the collection of middle meatus secretion samples and is an alternative method for determining microorganisms in rhinosinusitis. This study assessed endoscopically collected middle meatus secretions in patients with chronic rhinosinusitis (CRS) and compared those findings with ipsilateral maxillary sinus aspirates and microbiological data of healthy individuals. METHODS: Middle meatus samples were collected from 114 CRS patients for aerobic, anaerobic, and fungal cultures; maxillary sinus secretions were collected from 13 of these patients. Twenty-three healthy volunteers served as controls. RESULTS: Aerobes were isolated in 86% of CRS patients, anaerobes were isolated in 8% of CRS patients, and fungi were isolated in 11% of CRS patients; the most frequent microorganisms were Staphylococcus aureus (36%), coagulase-negative Staphylococcus (20%), and Streptococcus pneumoniae (17%). Middle meatus and maxillary sinus cultures presented the same pathogens in 80% of cases. In healthy individuals, coagulase-negative Staphylococcus (56%), S. aureus (39%), and S. pneumoniae (9%) were the most frequent isolates. CONCLUSION: The culture of endoscopically collected middle meatus secretions is effective in identifying microorganisms in CRS patients.     

Bacteriological findings and antimicrobial susceptibility in chronic sinusitis with nasal polyp

CONCLUSIONS: We recommend amoxacillin/clavulanate, cephalosporins and macrolides rather than penicillin as the first-line drug in chronic sinusitis with nasal polyps. In cases where there is no improvement of symptoms, cultures should be taken from the middle meatus, followed by appropriate selection of second-line antibiotics according to the sensitivity test results. OBJECTIVE: To investigate the causative bacteria and the antimicrobial susceptibility in patients with chronic sinusitis and nasal polyps in Korea. MATERIALS AND METHODS: The bacteriology and antimicrobial susceptibility of maxillary sinus aspirates from 81 patients were evaluated. RESULTS: Aerobes were isolated from 58.0% of the cultures from the middle meatus and from 48.1% of those from the maxillary sinus. Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae were the most prevalent aerobic pathogens. Anaerobes were isolated from 8.6% of the cultures from the middle meatus and from 18.5% of the cultures from the maxillary sinus. The predominant anaerobic organisms were Prevotella and Peptostreptococcus in adults but none of them were cultured in children. A high rate of concordance of the middle meatus and maxillary sinus was noted. Monomicrobial infection was most commonly observed. Ampicillin-resistant H. influenzae isolates were cultured in 46% of the cases. Penicillin resistance rates were 93% for Staph. aureus; 25% of Strep. pneumoniae were intermediate and 25% were resistant.