Nosocomial Sinusitis in Patients in the Medical Intensive Care Unit: A Prospective Epidemiological Study

A prospective observational cohort study of nosocomial sinusitis was carried out in two medical intensive care units. Sinusitis was diagnosed by computed tomographic scanning and the culture of sinus fluid obtained by puncture of a maxillary sinus. Clinical and epidemiological data were collected at...

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Bibliographic Details
Published in:	Clinical infectious diseases Vol. 27; no. 3; pp. 463 - 470
Main Authors:	George, David L., Falk, Pamela S., Meduri, G. Umberto, Leeper, Kenneth V., Wunderink, Richard G., Steere, Elaine L., Nunnally, F. Kent, Beckford, Neal, Mayhall, C. Glen
Format:	Journal Article
Language:	English
Published:	Chicago, IL The University Chicago Press 01-09-1998 University of Chicago Press
Subjects:	Bacterial diseases Biological and medical sciences Clinical Articles Cohort Studies Cross Infection - diagnostic imaging Cross Infection - epidemiology Cross Infection - microbiology Ent and stomatologic bacterial diseases Hospital admissions Human bacterial diseases Humans Incidence Infections Infectious diseases Intensive Care Units Intubation Male Maxillary sinus Medical intensive care units Medical sciences Microorganisms Middle Aged Paranasal Sinuses - diagnostic imaging Paranasal Sinuses - microbiology Predisposing factors Prospective Studies Radiography Risk Factors Sinuses Sinusitis Sinusitis - diagnostic imaging Sinusitis - epidemiology Sinusitis - microbiology Human Nosocomial infection Epidemiology Sinusitis Intensive care unit Incidence Infection Microbiological investigation Etiology Bacteriosis ENT disease Paranasal sinus disease Diagnosis
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Summary:	A prospective observational cohort study of nosocomial sinusitis was carried out in two medical intensive care units. Sinusitis was diagnosed by computed tomographic scanning and the culture of sinus fluid obtained by puncture of a maxillary sinus. Clinical and epidemiological data were collected at the time of admission to the unit and daily thereafter. Specimens from the nares, oropharynx, trachea, and stomach were cultured on admission and daily thereafter. The cumulative incidence of nosocomial sinusitis was 7.7%, and the incidence rates were 12 cases per 1,000 patient-days and 19.8 cases per 1,000 nasoenteric tube-days. Risk factors for nosocomial sinusitis, as determined by multiple logistic regression analysis, included nasal colonization with enteric gram-negative bacilli (odds ratio [OR], 6.4; 95% confidence interval [95% CI], 2.2–18.8; P = .007), feeding via nasoenteric tube (OR, 14.1; 95% CI, 1.7–117.6; P = .015), sedation (OR, 15.9; 95% CI, 1.9–133.5; P = .011), and a Glasgow coma score of ⩽7 (OR, 9.1; 95% CI, 3.0–27.3; P = .0001).
Bibliography:	ark:/67375/HXZ-RR2VZSSW-V Reprints or correspondence: Dr. C. Glen Mayhall, Division of Infectious Diseases, Route 0835, The Sealy Smith Building, The University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas 77555-0835. istex:F7E764A7E0210B020ED25566D2EC469667F6DC27 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1058-4838 1537-6591
DOI:	10.1086/514711