Bacterial Pathogens in the Nasopharynx, Nasal Cavity, and Osteomeatal Complex during Wellness and Viral Infection. Issue 1 (January 2013) - Rawlings, Brad A.
Background: Viral sinusitis can precede acute bacterial sinusitis, but the influence of viral infection on bacterial colonization is unclear. The objective of this study was to evaluate the presence of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in the osteomeatal complex (OMC), nasal cavity, and nasopharynx in adults during wellness and viral upper respiratory illness (URI). Methods: Subjects were recruited for the study during wellness and at the time of acute viral rhinosinusitis. Swab cultures were obtained from the OMC, nasal cavity, and the nasopharynx. Swab eluates were inoculated on selective agars to detect S. pneumoniae, H. influenzae, and M. catarrhalis. Results: The study included 237 subjects, 100 adults with URI and 137 well adults. Positive culture results were found for any site in 70% (n = 70) of ill subjects and 64% (n = 88) of well subjects (p = 0.393). Of the 91 OMC cultures, positive cultures were over five times more likely to be found in ill subjects than in well subjects (31% versus 8%; p = 0.010). The nasal cavity cultures were positively statistically significant more often in ill subjects versus well subjects (39% versus 25%; p = 0.022). The overall nasopharyngeal cultures did not show a statistically significant difference (65% versus 60%; odds ratio, 1.2; p = 0.461). S. pneumoniae was positively cultured in at least one site in 15% of ill subjects and 31% of well subjects (p = 0.006). H. influenzae was positively cultured in at least one site in 45% of ill subjects and 31% of well subjects (p = 0.027). M. catarrhalis was positively cultured in at least one site in 42% of ill subjects and 27% of well subjects (p = 0.018). Conclusion: This study defines the carriage rates of the three most common bacterial pathogens for acute sinusitis in the nasopharynx, nasal cavity, and OMC during illness and in the healthy state.