Perfil microbiológico en los pacientes con diagnóstico de sinusitis nosocomial hospitalizados en la Unidad de Cuidados Intensivos del Hospital de San José durante el período de Febrero de 2013 a Marzo de 2015. Microbiological profile in patients diagnosed with nosocomial sinusitis hospitalized in the Intensive Care Unit of the Hospital of San Jose during the period February 2013 to March 2015.

Objetivo: Determinar los agentes microbianos más frecuentes en pacientes de UCI con diagnóstico de sinusitis nosocomial en el Hospital de San José, período de dos años. Diseño: Estudio observacional tipo serie de casos. Materiales y métodos: Se incluyeron pacientes mayores de 18 años con una estancia hospitalaria mayor a 48 horas, que desarrollaron sinusitis nosocomial de acuerdo a los criterios de los Centers for Disease Control (CDC). Uso de dos técnicas: punción y lavado de seno maxilar. Resultados: 19 pacientes que cumplen los criterios de sinusitis nosocomial. Edad promedio 55 años, predominio sexo masculino. El 94.7% tuvo sonda orogástrica, 89.5% intubación orotraqueal y 89.5% ventilación mecánica. Hubo aislamiento polimicrobiano de gram positivos, gram negativos, anaerobios y hongos. La mortalidad en UCI fue 32%. Conclusiones: Se presenta una adecuada sensibilidad al tratamiento con vancomicina y piperacilina tazobactam en esta patología. El rendimiento diagnóstico es igual al realizar lavado y punción del seno maxilar.Objetive: To determine the microbial agents on UCI patients who have beendiagnosed with nosocomial sinusitis at the San Jose Hospital, (Bogota, Colombia) in a two-year period. Design: Case series study. Materials and methods: Patients who were older than 18-year olds, with a hospitalization longer than 48 hours who developed nosocomial sinusitis, according to the criteria established by the Centers for Disease Control (CDC) were included. Two techniques were employed for data collection: puncture and maxillary sinus wash. Results: 19 patients fulfill the criteria requirements for nosocomial sinusitis. Average age was 55 years old. Population mostly was composed by male individuals. 94.7% had a gastric tube intervention; 89.5% had tracheal intubation 89.5% mechanical ventilation. Polymicrobial isolation with gram positive, gram negative, anaerobic and fungi were identified. Mortality in critical care unites was 32%. Conclusions: An adequate sensitivity to treatment with vancomycin and piperacillin tazobactam was evidenced in this pathology.To perform a washing or maxillary sinus puncture had the same efficiency fordiagnosing this disease.

Incidence of Sinusitis Associated With Endotracheal and Nasogastric Tubes: NIS Database

Background Endotracheal and nasogastric tubes are recognized risk factors for nosocomial sinusitis. The extent to which these tubes affect the overall incidence of nosocomial sinusitis in acute care hospitals is unknown. Objective To use data for 2008 through 2013 from the Nationwide Inpatient Sample database to compare the incidence of sinusitis in patients with nasogastric tubes with that in patients with an endotracheal tube alone or with both an endotracheal tube and a nasogastric tube. Methods Patients’ data with any of the following International Classification of Disease, Ninth Revision, Clinical Modification codes were abstracted from the database: (1) 96.6, enteral infusion of concentrated nutritional substances; (2) 96.07, insertion of other (naso-)gastric tube; or (3) 96.04, insertion of an endotracheal tube. Sinusitis was defined by the appropriate codes. Weighted and unweighted frequencies and weighted percentages were calculated, categorical comparisons were made by χ2 test, and logistic regression was used to examine odds of sinusitis development by tube type. Results Of 1 141 632 included cases, most (68.57%) had an endotracheal tube only, 23.02% had a nasogastric tube only, and 8.41% had both types of tubes. Sinusitis was present in 0.15% of the sample. Compared with patients with only a nasogastric tube, the risk for sinusitis was 41% greater in patients with an endotracheal tube and 200% greater in patients with both tubes. Conclusion Despite the low incidence of sinusitis, a significant association exists between sinusitis and the presence of an endotracheal tube, especially when a nasogastric tube is also present.

S287 – Microbiological Study of Nosocomial Sinusitis in ICU

Objectives 1) Identifying the bacteria causing sinusitis in an intensive care unit (ICU) through the nasal swab and puncture of maxillary sinus. 2) Comparing their results with the cultures and antibiograma. Methods 22 patients in the ICU with uni- or bilateral maxillary sinusitis diagnosed by computed tomography were submitted to nasal swab and puncture of the maxillay sinus. The materials were sent to culture and antibiograma and their results were compared. Results The present study evaluated 22 patients. There was exact correlation among the isolated microbial agent in the swab and in the puncture in 14 of the 22 cases (63%). The prevalence of the aerobic gram negative was: Pseudomonas aeruginosa (29%), Proteus mirabillis (26%) and Acinetobacter baumanni (14%). The antibiograma presented a high index of resistance to the antibiotics used in daily practice. Conclusions The nasal swab was of little value to the diagnosis, while the direct puncture of the maxillary sinus could assess the specific bacterial agents, allowing a right-to-the-point therapeutic. The early and specific treatment decreases the morbi-mortality in these patients.