Comparison of endoscopically‐guided swab vs aspirate culture techniques in post–endoscopic sinus surgery patients: blinded, prospective analysis. Issue 9 (27th March 2013)

• Record Type: Journal Article
• Authors: Walgama, Evan; Thanasumpun, Thunchai; Gander, Rita; Batra, Pete S.
• Is Part Of: International forum of allergy & rhinology. Volume 3:Issue 9(2013:Sep.)
• Page Start: 726
• Page End: 730
• Publication Date: 2013-03-27
• Subjects: 617.51005
• DOI: 10.1002/alr.21170
• Languages: English
• ISSNs: 2042-6976

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="alr21170-sec-0010" sec-type="section"> <title>Background</title> <p>Culture‐directed antibiotic therapy remains imperative in the management paradigm of chronic rhinosinusitis (CRS). The objective of this study was to conduct a prospective, blinded comparison of endoscopically‐guided swab and aspirate cultures from the same sinonasal site in patients presenting with acute infectious exacerbations post–sinus surgery.</p> </sec> <sec id="alr21170-sec-0020" sec-type="section"> <title>Methods</title> <p>Forty‐nine CRS patients were prospectively enrolled in a tertiary care rhinology clinic. At the conclusion of the study, all cultures were unblinded to determine mean culture yield, most common pathogens, potential contaminants, and therapeutic correlation.</p> </sec> <sec id="alr21170-sec-0030" sec-type="section"> <title>Results</title> <p>The mean patient age was 49 years and 40.8% were males. All patients had evidence of symptomatic exacerbation with purulence on endoscopy at the time of presentation. There was a mean of 1.367 pathogens assayed per aspirate culture vs a mean of 1.102 per swab culture (<italic>p</italic> = 0.0032). The prevalence of <italic>Pseudomonas aeruginosa</italic> was 42% for aspirate vs 30% for swab cultures, respectively. The prevalence of <italic>Staphylococcus aureus</italic> was 49% for suction cultures vs 45% for swab cultures. There were 9 and 11 likely contaminants using aspirate and swab cultures, respectively. Therapeutic correlation was strong in 67%, moderate in 18%, and weak in 14% of patients.</p> </sec> <sec id="alr21170-sec-0040" sec-type="section"> <title>Conclusion</title> <p>This prospective analysis demonstrated higher culture yield, particularly with <italic>Pseudomonas</italic>, with aspirate vs swab cultures in postoperative patients. There is a strong clinical correlation between the 2 methods, and both aspirate and swab techniques serve as acceptable alternatives for endoscopic‐guided cultures in patients with post–functional endoscopic sinus surgery infectious exacerbations.</p> </sec> </abstract>