Pseudomonas aeruginosa Infection in Rhinosinusitis Patients

鼻炎及鼻竇炎病人之綠膿桿菌感染

廖昌昱(Chung-Yu Liao) ； 涂智文(Chih-Wen Twu) ； 江榮山(Rong-San Jiang)

《Mid-Taiwan Journal of Medicine》 10卷2期 (2005/06) Pp. 73-77

https://doi.org/10.6558/MTJM.2005.10(2).3

摘要

目的　綠膿桿菌在慢性鼻竇炎的培養結果中是屬於少見的致病菌。文獻記載顯示綠膿桿菌多發生於院內感染，免疫功能低下患者，及囊性纖維病變患者。本研究旨在探討鼻炎及鼻竇炎患者感染綠膿桿菌的特徵。
方法　我們以回溯性病例分析，收集自1999年1月至2001年12月間於台中榮聰耳鼻喉科門診診斷爲鼻炎及鼻竇炎且曾於療程中接受細菌培養之患者共580位。其中34位患者培養出綠膿桿菌，我們分析其臨床表現、相關性病症、治療方式以及治療結果。
結果　細菌培養顯示綠膿桿菌感染者共34位，佔5.9%。同時有過敏性鼻炎者14位，鼻中隔彎曲者5位，萎縮性鼻炎3位，慢性肥厚性鼻炎3位。過去曾接受鼻竇手術者有15位。除1位患者外其餘皆依藥物感受性檢驗給予抗生素治療，而需接受功能性內視鏡鼻竇手術有8位。追蹤期間，4位病患沒有獲得改善，另有20位病患復發鼻及鼻竇炎。在復發的病患當中，有3位病患再度培養出綠膿桿菌。
結論　本研究顯示接受過鼻竇手術的病患較容易感染綠膿桿菌。受綠膿桿菌感染之鼻炎及鼻竇炎患者需要長期且持續性的照顧。

關鍵字

綠膿桿菌 ； 鼻竇炎

並列摘要

Purpose. Pseudomonas aeruginosa is as an uncommon cause of chronic rhinosinusitis. Pseudomonas aeruginosa rhinosinusitis has been noted in patients with nosocomial infection, immunocompromised patients and patients with cystic fibrosis. In this study, we investigated the clinical features of Pseudomonas aeruginosa infection in rhinosinusitis patients.
Methods. We retrospectively studied bacterial cultures obtained from 580 rhinosinusitis patients from January 1999 to December 2001. The files of patients whose cultures grew Pseudomonas aeruginosa were reviewed.
Results. The bacteriologic cultures showed Pseudomonas aeruginosa infection in 34 patients (5.9%). Concurrent nasal diseases in these patients included allergic rhinitis (14 patients), deviation of nasal septum (5 patients), atrophic rhinitis (3 patients) and chronic hypertrophic rhinitis (3 patients). Fifteen patients had a history of sinus surgery. All patients except for one underwent antibiotic treatment according to a drug sensitivity test, and 8 patients required subsequent functional endoscopic sinus surgery. During follow-up, the condition of 4 patients did not improve and rhinosinusitis recurred in 20 patients. Pseudomonas aeruginosa was cultured again in 3 patients with recurrent rhinosinusitis.
conclusions. This study indicates that patients with a history of sinus surgery are at risk of Pseudomonas aeruginosa infection. Long-term continuous care is needed to treat patients with Pseudomonas aeruginosa rhinosinusitis.

並列關鍵字

Pseudonomas aeruginosa ； rhinosinusitis