Microbiology of acute complicated bacterial sinusitis at the University of the Witwatersrand

Design. A retrospective chart review study at two referral hospitals identified 226 consecutive surgical patients with acute complicated sinusitis. Subjects. One hundred and fifty-nine male and 67 female patients, with a mean age of 16.5 (standard deviation 0.7) years, underwent external fronto-ethmoidectomy with maxillary sinus washout and 13 had a concurrent craniotomy. Results. A total of 233 micro-organisms were isolated from 163 patients(72.1%), and 63 (27.9%) were culture-negative. Positive isolates included Streptococcus milleri (18.5%), Staphylococcus aureus (12.4%), β-haemolytic streptococci (10.8%), coagulase-negative staphylococci (8.6%), Haemophilus influenzae (8.6%) and the anaerobes, Peptostreptococcus (6.4%) and Prevotella (4.7%) species. The prevalences of S. pneumoniae (2.6%), methicillin-resistant S. aureus (MRSA) (1.3%) and Moraxella catarrhalis (0.4%) were low. Polymicrobial disease was present in 56 patients (34.4%). There was a significant difference between the two hospitals in the prevalences of some bacteria (