RESUMEN
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.
Asunto(s)
Cavidad Nasal/microbiología , Rinitis Alérgica Perenne/microbiología , Sinusitis/microbiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacterias/clasificación , Bacterias/aislamiento & purificación , Brasil , Niño , Preescolar , Enfermedad Crónica , Recuento de Colonia Microbiana , Susceptibilidad a Enfermedades/microbiología , Farmacorresistencia Microbiana , Endoscopía , Femenino , Hongos/clasificación , Hongos/aislamiento & purificación , Humanos , Leucocitos , Masculino , Seno Maxilar/microbiología , Seno Maxilar/cirugía , Persona de Mediana Edad , Estudios Prospectivos , Rinitis Alérgica Perenne/cirugía , Sensibilidad y Especificidad , Sinusitis/cirugía , Estadística como AsuntoRESUMEN
O uso de métodos automatizados tem freqüentemente levado a falhas na identificação do gênero Enterococcus em laboratórios de microbiologia clínica. Neste estudo foi avaliada a utilização de um sistema automatizado Vitek (bioMérieux) em dois laboratórios de microbiologia clínica para identificação de diferentes espécies de enterococos. Os resultados foram comparados com os testes fisiológicos convencionais. As amostras (80) foram inoculadas em testes bioquímicos convencionais e no cartão Vitek GPI. No geral, a concordância entre os dois métodos foi de 83,7% (67/80). Entre as amostras de E. faecalis, o sistema Vitek identificou corretamente 35/40 (87,5%) e entre os E. faecium, a concordância foi 12/14 (85,7%). Em 20/26 amostras (76,9%) pertencentes a espécies não-E. faecalis e não-E. faecium, o sistema chegou à identificação correta. Os resultados do presente estudo mostram que o sistema Vitek necessita de melhorias para a identificação de enterococos, especialmente diante de espécies menos freqüentes.
Automated systems may present problems in the identification of members of the genus Enterococcus in clinical laboratories. Having conventional physiological tests as the reference method, we evaluated the use of an automated system (VITEK bioMérieux) in the identification of 80 isolates belonging to different species of Enterococcus. The general agreement between results obtained by the conventional method and by the Vitek GPI card was 83.7% (67/80). Among isolates of E. faecalis and E faecium we observed that the automated system correctly identified 35/40 (87.5%) and 12/14 (85.7%) of the strains, respectively. Among isolates belonging to species which are neither E. faecalis, nor E. faecium, it was observed an agreement of 20/26 (76.9%). Results point to the need of improvement in the automated systems to identify enterococci. Special consideration must be taken regarding less frequently isolated species.