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Itzhak Brook, MD, MSc; Paula Yocum, MSc; Edith H. Frazier, MSc; John G. Bartlett, MD

Arch Otolaryngol Head Neck Surg. 1996;122(4):418-423.

Abstract
Objective
To assess the bacteriology and β-lactamase enzyme activity in aspirates of 10 acutely and 13 chronically inflamed maxillary sinuses.

Results
The predominant organisms isolated in acute sinusitis were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, and those found in chronic sinusitis were Prevotella species, Fusobacterium species, and Peptostreptococcus species. Four β-lactamase-producing organisms (BLPOs) were isolated in four specimens (40%) obtained from acutely inflamed sinuses, and 14 BLPOs were recovered from 10 chronically inflamed sinuses (77%). The predominant BLPOs in acute sinusitis were H influenzae, and M catarrhalis; those in chronic sinusitis were Staphylococcus aureus, Prevotella species, Fusobacterium species, and Bacteroides fragilis.

Conclusions
β-Lactamase activity was detected in 12 (three in acute and nine in chronic sinusitis) of the 14 aspirates that contained BLPOs. The detection of β-lactamase activity in sinus aspirates provides support for the role of BLPOs in the failure of penicillin therapy in sinusitis.

(Arch Otolaryngol Head Neck Surg. 1996;122:418-423)

Author Affiliations
From the Departments of Pediatrics and Infectious Diseases, Naval Medical Center, Bethesda, Md.

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