Bacteriological findings of acute maxillary sinusitis in young adults

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Abstract
Bacteriological findings in 339 sinus secretions obtained by puncture were investigated in 238 young adult patients with acute maxillary sinusitis. Aerobic and anaerobic cultures were performed immediately. A total of 76% of the secretions were positive. The most common pathogens isolated were Haemophilus influenzae (50%), Streptococcus pneumoniae (19%), Streptococcus pyogenes (5%), and Branhamella catarrhalis (2%). Coagulase-negative staphylococci and Staphylococcus aureus were isolated in 8 and 1% of the specimens, respectively. The staphylococci were almost invariably present in low numbers and, therefore, probably represented nasal contamination. Other aerobic species were found only occasionally. Anaerobes were isolated in 5% of the secretions. In one-half of these, a low concentraion of Propionibacterium acnes was the sole anaerobe that was found, and it was usually mixed with a facultative organism (suggestive of contamination with nasal flora). Only 2% of the sinuses were considered to have true anaerobic infections (high concentrations of several species typical of anaerobic infection), indicating that anaerobes are not a significant cause of acute maxillary sinusitis in a young adult population. The high recovery of H. influenzae in this study indicates that aminopenicillins may be a more appropriate choice than conventional penicillin in the antimicrobial therapy of acute maxillary sinusitis (only 2 of 168 H. influenzae strains produced .beta.-lactamase).