Skip to main content Accessibility help

Bacteriology of chronic purulent secretions in chronic rhinosinusitis

  • Jean-Michel Klossek (a1), Luc Dubreuil (a2), Hervé Richet (a3), Béatrice Richet (a3) and Patrice Beutter (a4)...


The aim of this work was to study the bacterial flora of purulent secretions during chronic rhinosinusitis. We studied a total of 533 patients divided into two groups. The control population consisted of 139 adults (> 16 years) of both sexes seen in the community or hospitalized for less than 72 hours for non-rhinological conditions. The rhinosinusitis group consisted of 394 patients referred to the ENT clinic with chronic rhinosinusitis. All the patients with rhinosinusitis had had a post-nasal discharge for at least three months, associated with purulent or mucopurulent secretions originating from the involved sinus cavity. All samples were obtained endonasally under endoscopic guidance from the sinus ostium or from the sinus cavity during surgery. Cultures were positive in 81.3 per cent of the control subjects and 83.1 per cent of the patients with rhinosinusitis.

Corynebacteria, coagulase-negative staphylococci, propionibacteria and peptostreptococci were the main commensal organisms, while Haemophilus influenzae, streptococci, Streptococcus pneumoniae, Prevotella spp and Fusobacterium spp were probable causative pathogens. Anaerobes were isolated from approximately 25 per cent of the patients in the rhinosinusitis group. Betalactamase producers represented 27.5 per cent of H. influenzae and 28 per cent of Prevotella spp isolates. Diminished susceptibility to penicillin was found in 13 per cent of S. pneumoniae isolates. The amoxycillin-clavulanate combination was the most active oral antibiotic tested against the pathogenic species in vitro.


Corresponding author

Address for correspondence: Professor J. M. Klossek, Service ORL et Chirurgie cervicofaciale, Hôpital Jean Bernard CHU Poitiers, BP577 86021 Poitiers Cédex, France. Fax: (33)549443848


Hide All

Presented at the meeting REESPIR Paris, 26–27 January 1995.



Hide All
Almadori, G., Bastianini, F., Maurizi, M., Paludetti, G., Scuteri, F. (1986) Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis. Rhinology 24: 257264.
Axelsson, A., Brorson, J. E. (1973) The correlation between bacteriological findings in the nose and maxillary sinus in acute sinusitis. Laryngoscope 83: 20032011.
Brook, I. (1981) Aerobic and anaerobic bacterial flora of normal maxillary sinuses. Laryngoscope 91: 372376.
Brook, I., Thompson, D., Frazier, E. (1994) Microbiology and management of chronic maxillary sinusitis. Archives of Otolaryngology–Head and Neck Surgery 120: 13171320.
Dabernat, H., Delmas, C. (1996) Activité du Centre National de Référence pour Haemophilus influenzae, bilan 1994–1995. Les débuts de l'après vaccination. Medecine Maladie Infectieuses 26: 698703.
Davidson, T. M., Brahme, F. J., Gallagher, M. E. (1989) Radiographic evaluation for nasal dysfunction: computed tomography versus plain films. Head and Neck 11: 405409.
Erkan, M., Aslan, T., Ozcan, M., Koç, N. (1994) Bacteriology of antrum in adults with chronic maxillary sinusitis. Laryngoscope 104: 321323.
Gwaltney, J. M. Jr. (1995) Sinusitis. In Principles and Practice of Infectious Diseases 4th Edition. (Mandell, G. L., Bennett, J. E., Dolin, R., eds.) Churchill Livingstone, New York, pp 585590.
Hartog, B., Degener, J. E., Van Benthem, G., Hordijk, G. J. (1995) Microbiology of chronic maxillary sinusitis in adults: Isolated aerobic and anaerobic bacteria and their susceptibility to 20 antibiotics. Acta Otolaryngologica (Stockh) 155: 672677.
Jousimies-Somer, H., Savolainen, S., Ylikoski, J. (1988) Macroscopic purulence, leucocyte counts and bacteriological morphotypes in relation to cultures findings for sinus secretions in acute maxillary sinusitis. Journal of Clinical Microbiology 26: 19261933.
Jousimies-Somer, H., Savolainen, S., Ylikoski, J. (1989) Comparison of the nasal bacterial floras in two groups of healthy subjects and in patients with acute maxillary sinusitis. Journal of Clinical Microbiology 27: 27362743.
Klossek, J. M., Dubreuil, L., Richet, B., Sedaillan, A., Beutter, P. (1996) Bacteriology of the adult middle meatus. Journal of Laryngology and Otology 110: 847849.
Loch, W. E., Allava, M., Paparella, M. (1990) Sinusitis. Primary Care 17: 323334.
Lund, V. J., Kennedy, D. W. (1995) Quantification for staging sinusitis. The Staging and Therapy Group. Annals of Otology, Rhinology and Laryngology – Supplement (167): 1721.
Lundberg, C., Engquist, S. (1984) Localization of bacteria and the cause of tissue destruction in maxillary sinusitis. Acta Otolaryngologica (Stockh) S407: 3032.
Rowe-Jones, J., Mackay, I. (1995) Sinusitis and rhinitis or rhinosinusitis? British Medical Journal 310: 610 (Letter).
Savolainen, S., Ylikoski, J., Jousimies-Somer, H. (1987) Predictive value of nasal bacterial culture for etiological agents in acute maxillary sinusitis. Rhinology 28: 4955.
Savolainen, S., Ylikoski, J., Jousimies-Somer, H. (1989) Differential diagnosis of purulent and non-purulent acute maxillary sinusitis in young adults. Rhinology 27: 5361.
Sobin, J., Engquist, S., Nord, C. E. (1992) Bacteriology of the maxillary sinus in healthy volunteers. Scandinavian Journal of Infectious Diseases 24: 633635
Su, W. Y., Liu, C., Hung, S. Y., Tsai, W. F. (1983) Bacteriological study in chronic maxillary sinusitis. Laryngoscope 93: 931934.
Suzuki, K., Nishiyama, Y., Sugiyama, K., Miyamoto, N., Baba, S. (1996) Recent trends in clinical isolates from paranasal sinusitis. Acta Otolaryngologica (Suppl 525): 5155.
Van Cauwenberge, P. B., Van der Mijnsbrugge, A. M., Ingels, K. J. A. O. (1993) The microbiology of acute and chronic sinusitis and otitis media: a review. European Archives of Otorhinolaryngology 250: S3–6.


Related content

Powered by UNSILO

Bacteriology of chronic purulent secretions in chronic rhinosinusitis

  • Jean-Michel Klossek (a1), Luc Dubreuil (a2), Hervé Richet (a3), Béatrice Richet (a3) and Patrice Beutter (a4)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.