| چکیده انگلیسی مقاله |
Background: Nosocomial rhino sinusitis is a major problem in all Intensive Care Units. Objective: To describe incidence, epidemiology, clinical manifestations, and microbiologic findings in ICU admitted cases with nosocomial sinusitis. Methods& Materials: A prospective, cross sectional study conducted at the Pediatric & Adult ICUs of 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 was proven in 82% (51/ 63) of all cases.Head trauma was the most common cause; (n=22, 45%) of cases. Of 45 culture positives, 19 yielded Gram negative organisms (41%) and 9 (22%) gave Gram positives (S, aureus, Streptococus spp). The remainders (n=17, 37%) consisted of mixed aerobic/anaerobic. Positive gram stain or rapid test of sinus drainage was obtained from 7 cases: five tested positive for S.Pneumonia, two tested positive for H.inf . The type of organism was not related to the Glasgow Coma Scale of patients ( 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 of the broad-spectrum antibiotics. |
