Bacteriological Characteristics Of Nasal Cavity In Children With Chronic Sinusitis

Objective :To explore the bacteriological characteristics of nasal secretions in children with chronic sinusitis.Methods : Select the standard cases among children with CRS who were hospitalized in our hospital from September 2014 to September 2019.According to nasal endoscopy,sinus CT examination and postoperative pathology report,the children were divided into two groups: CRSw NP and CRSs NP.In addition,patients who were hospitalized with nasal septum deviation,nasal vestibular cyst and other diseases were selected as the control group.Results: In this experiment,there were a total of 103 cases of 120 children in the experimental group that cultured effective bacterial colonies,and the positive rate was 85.8%(the positive rate of CRSw NP group was 88.3%,and the positive rate of CRSs NP group was 83.3%).Children in the experimental group whose culture results were negative A total of 17 cases,including 7 children in the CRSw NP group and 10 children in the CRSs NP group.Among the 53 children in the CRSw NP group whose culture results were positive,37 colonies of coagulase-negative staphylococci were cocultured,9 of streptococcus Strains,9 strains of Corynebacterium,8 strains of Moraxella catarrhalis,6 strains of Haemophilus parainfluenzae,8 strains of Haemophilus influenzae,4 strains of Staphylococcus aureus,3 strains of Enterobacter,and Actinobacillus 2 Strain.Among the 50 children with positive culture results in the CRSs NP group,35 coagulase-negative staphylococcal colonies,7 strains of Streptococcus,7 strains of Moraxella catarrhalis,5 strains of Haemophilus parainfluenzae,and influenza 3 strains of Haemophilus,2 strains of Corynebacterium and 2 strains of Staphylococcus aureus.In the control group,54 cases of children’s nasal secretions were cultured positively,with a positive culture rate of 67.5%,including 32 coagulase-negative staphylococcal colonies,16 catarrhalis and Streptococcus(Streptococcus pneumoniae)12 strains,9 strains of Haemophilus parainfluenzae,7 strains of Corynebacterium,6 strains of Haemophilus influenzae,5strains of Enterobacter,4 strains of Staphylococcus aureus,can be found whether it is CRSw NP group,CRSs NP group or control group,Coagulase-negative staphylococci are the most common.In the CRSw NP group,CRSs NP group and control group,only1,2and 1 anaerobic bacteria were found.The comparison of samples between the CRSw NP group and the CRSs NP group did not find statistical significance(P>0.05),while comparing the experimental group(the CRSw NP group and the CRSs NP group)with the non-CRS group of children,it can be found that the bacterial diversity There was statistical significance,and the characteristics of bacteria in the nasal cavity of children with CRS were different from those of other children(P>0.05).The bacteriological statistics of the children with adenoid hypertrophy in the experimental group were compared with those without adenoid hypertrophy.It was found that there was a difference in the detection rate of Staphylococcus aureus(P <0.05).Streptococcus,Staphylococcus aureus,and coryneform bacteria are generally intolerant to vancomycin,clindamycin,third-generation cephalosporins such as cefoperazone,and β-lactam antibiotics such as oxacillin,but are generally intolerant to broad-spectrum Antibiotics such as penicillin,macrolide antibiotics clarithromycin,and sulfonamides can show drug resistance.Enterobacter and Moraxella catarrhalis are sensitive to antibiotics such as sulbactam and cefixime,and partly tolerant to ceftazidime,amikacin,and amoxicillin and clavulanic acid in combination.Conclusion:Regardless of whether children with CRS or not,aerobic bacteria occupy most of the nasal flora in the nasal cavity.The common flora in nasal samples of children with CRS include coagulase-negative staphylococcus and streptococcus(Streptococcus pneumoniae),Moraxella catarrhalis,Corynebacterium,Haemophilus influenzae and Haemophilus parainfluenzae,etc.;In comparison,children with CRS are more likely to cultivate one or several bacterial groups in the nasal cavity,which is more suitable for bacterial growth;The incidence of chronic sinusitis in children does not lie in the abnormal increase of a certain bacteria,but in the nasal cavity of children under the pathological state of CRS(whether polyps are present or not),the bacterial diversity appears to be reduced;adenoid hypertrophy has an effect on the nasal cavity of children with CRS There is an impact on the characteristics of the flora and the incidence.The results of drug susceptibility test on the nasal flora of children with CRS showed that streptococcus,Staphylococcus aureus,and coryneform bacteria all showed strong resistance to penicillin and clarithromycin.Moraxella catarrhalis and Enterobacter show high resistance to ampicillin and gentamicin.It is recommended to use cefixime,amoxicillin/clavulanic acid or cefoperazone/sulbactam and other combined preparations for children,in order to obtain an ideal inflammation control effect.