慢性鼻-鼻窦炎伴或不伴鼻息肉的细菌培养分析

目的：研究慢性鼻-鼻窦炎中细菌的分布，比较慢性鼻-鼻窦炎伴和不伴鼻息肉患者及正常对照患者中鼻道分泌物的细菌学特征。方法：回顾性分析72名慢性鼻-鼻窦炎不伴鼻息肉(chronic rhinosinusitis without nasal polyps，CRSsNP)患者、65名慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps，CRSwNP)患者和40名正常对照者鼻道分泌物中细菌培养的阳性率和分布。结果：细菌经培养后，CRSwNP，CRSsNP及对照组的阳性率分别为81.9%，80.0%和82.5%，3组间比较差异无统计学意义(P>0.05)。需氧菌主要为凝固酶阴性葡萄球菌、金黄色葡萄球菌、链球菌属、棒状杆菌属，厌氧菌主要为梭杆菌属，3组间比较差异亦无统计学意义(P>0.05)。结论：CRSsNP，CRSwNP和对照组培养出的细菌分布没有明显的差异。细菌感染并非是慢性鼻-鼻窦炎伴或不伴鼻息肉发病机制中的唯一因素。

Bacterial culture analysis for patients with chronic rhinosinusitis with or without polyps

Objective: To determine the distribution of bacteria in patients with chronic rhinosinusitis, and to compare the bacteriologic features in middle meatus specimens between patients with nasal polyps (CRSwNP) and patients without nasal polyps (CRSsNP). Methods: We retrospectively analyzed the positive rate and types of bacterial culture in middle meatus specimens from 40 controls, 65 patients with CRSwNP, and 72 patients of CRSsNP. The specimens from the middle meatus were obtained during endoscopic sinus surgery. Results: The positive rates of bacteria for CRSwNP, CRSsNP and the controls 81.9%, 80.0% and 82.5%, respectively, with no significant difference among the 3 groups. The common aerobe bacteria found in the specimens was Coagulase-negative staphylococci, Staphylococcus aureus, Streptococcus and Corynebacterium. The common anaerobe was Fusobacterium. The positive rates for aerobic and anaerobic bacteria showed no significant differences among the 3 groups. Conclusion: The distribution of bacteria in middle meatus specimens is not significantly different among CRSwNP, CRSsNP and the controls. Therefore, bacterial infection may not play a key role in the pathogenesis of CRS patients with and without nasal polyos.