Microbial Analysis in Chronic Rhinosinusitis Patients with Chronic Kidney Disease and End-Stage Renal Disease.

Autor: Lo SW; Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan., Ding MC; Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan., Tsai YT; Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.; Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Tsai MS; Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.; Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Liu CY; Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan., Hsu CM; Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.; Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Yang YH; Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.; Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Chang GH; Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.; Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.; Head and Neck Infection Treatment Center, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2024 Aug; Vol. 134 (8), pp. 3499-3507. Date of Electronic Publication: 2024 Mar 09.
DOI: 10.1002/lary.31389
Abstrakt: Introduction: This study aimed to elucidate the bacterial profile of chronic rhinosinusitis (CRS) in patients with end-stage renal disease (ESRD) and chronic kidney disease (CKD) compared with nonrenal patients, guiding antibiotic selection for clinicians.
Methods: We retrospectively analyzed 13,906 inpatients from the Chang Gung Research Database who underwent sinus surgery (2004-2018). Patients were categorized into ESRD-CRS, CKD-CRS, and non-CKD-CRS based on the estimated glomerular filtration rate. Bacterial cultures from surgical samples were classified as facultative anaerobes or aerobes (e.g., Klebsiella pneumoniae [KP], Pseudomonas aeruginosa [Ps.a]), anaerobes, and fungi and ranked by prevalence.
Results: Data from 47 ESRD-CRS, 230 CKD-CRS, and 13,123 non-CKD-CRS patients were analyzed. In ESRD-CRS, the predominant species were KP (31.6%), Ps.a (21.1%), and Coagulase-negative Staphylococcus (CoNS, 15.8%). CKD-CRS showed Staphylococcus epidermidis (27.7%), CoNS (20.5%), and Ps.a (20.5%). Non-CKD-CRS had Staphylococcus epidermidis (29.8%), CoNS (25.0%), and Staphylococcus aureus (15.5%). For anaerobes, ESRD-CRS was dominated by Fusobacterium nucleatum (10.5%) and Peptostreptococcus micros (10.5%), whereas CKD-CRS and non-CKD-CRS showed Propionibacterium acnes as a primary strain (14.5% and 28.7%, respectively).
Conclusion: For CRS in ESRD, antibiotics targeting KP and Fusobacterium nucleatum are recommended. In CKD-CRS, a focus on Staphylococcus epidermidis and Propionibacterium acnes is suggested.
Level of Evidence: 4 Laryngoscope, 134:3499-3507, 2024.
(© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
Externí odkaz: