Intensive Care Unit nosocomial sinusitis at the Rasoul Akram Hospital: Tehran, Iran, 2007-2008
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S Noorbakhsh
,
M Barati
,
M Farhadi
,
J Mousavi
,
V Zarabi
,
A Tabatabaei
Abstract
Background: Nosocomial rhino sinusitis causes major problems in all Intensive Care Units (ICUs).
Objective: To describe incidence, epidemiologic, clinical manifestations, and microbiologic findings in ICUs admitted cases with nosocomial sinusitis.
Materials and Methods: A prospective, cross sectional study done in Pediatric & Adult ICUs in Rasoul Akram Hospital; Tehran Iran (2007-2008). Para-nasal sinus computed tomography (CT) was performed in all adults with fever of unknown origin (FUO) within 48h of admission and repeated thereafter (4-7 days). Infectious sinusitis was diagnosed by microbiological analysis of sinus fluid aspirates.
Results: Acute bacterial nosocomial sinusitis proved in 82% (51/ 63) of all cases. Head trauma was the most common cause (n = 22, 45%) of cases. The results of culture were positive for 45 cases (82%). Of 45 culture positives, 19 yielded Gram negative organisms (41%) and 9 (22%) gave Gram positives (S. aureous, Streptococus spp). The remainders (n = 17, 37%) consisted of mixed aerobic/anaerobic bacteria.Seven cases, were positive in gram staining of sinus drainage and these were positive in culture for S. pneumonia (n = 5), Hemophilus influenza (n = 2). The type of organisms were not related to Glasgow Coma Scale in cases (P = 0.3).
Conclusion: Nosocomial organisms isolated were quite different from community acquired rhino sinusitis cases. Investigation of CT scan and drainage of Para-nasal sinuses would be helpful in undiagnosed FUO cases, especially in traumatic patients. Optimal treatment usually consists of removal of the tubes, mobilizing the patient, and administration the broad-spectrum antibiotics.
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| Issue | Vol 4 No 3 (2012) | |
| Section | Articles | |
| Keywords | ||
| Intensive Care Units (ICUs) Nosocomial infection Nosocomial rhino sinusitis Sinusitis | ||
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