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Nasal Carriage of 200 Patients with Nasal Bone Fracture in Korea

  • Lee, Jun Wook (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Young Joon (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Hoon (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Nam, Sang Hyun (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Shin, Bo Moon (Department of Laboratory Medicine, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Choi, Young Woong (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine)
  • Received : 2013.04.25
  • Accepted : 2013.06.27
  • Published : 2013.09.15

Abstract

Background Pathogens in the nasal cavity during nasal surgery could lead to a systemic infectious condition, such as bacteremia, nosocomial infection, or toxic shock syndrome. However, there is no research about the prevalence of nasal carriage in patients with nasal bone fracture. Methods This was a prospective, double-blind, randomized study about the rate of nasal carriage in 200 patients with nasal bone fracture in Korea. Nasal secretions were taken from both the middle nasal meatus and colonized. All analyses were carried out using SPSS software. Results Pathogens were identified in 178 of the 200 cases. Coagulase-negative staphylococci (CNS) were the most cultured bacteria in 127 (66.84%) of the 190 total patients after excluding 10 cases of contaminated samples, and methicillin-resistant coagulase-negative staphylococci (MRCNS) were found in 48 (25.26%). Staphylococcus aureus was the second most identified pathogen, found in 36 (18.95%), followed by 7 cases (3.68%) of methicillin-resistant Staphylococcus aureus (MRSA). The prevalence rate of MRSA in the females was higher than that in the males (RR=4.70; 95% CI, 1.09-20.18), but other demographic factors had no effect on the prevalence rate of MRSA and MRCNS. Conclusions The prevalence rate of these pathogens in patients with nasal bone fracture in Korea was similar to other reports. However, few studies have addressed the prevalence rate of CNS and MRCNS in accordance with risk factors or the change in prevalence according to specific prophylaxis against infectious complications. Additional research is needed on the potential connections between clinical factors and microbiological data.

Keywords

References

  1. van Rijen MM, Bonten M, Wenzel RP, et al. Intranasal mupirocin for reduction of Staphylococcus aureus infections in surgical patients with nasal carriage: a systematic review. J Antimicrob Chemother 2008;61:254-61.
  2. Gluck U, Gebbers JO. The nose as bacterial reservoir: important differences between the vestibule and cavity. Laryngoscope 2000;110:426-8. https://doi.org/10.1097/00005537-200003000-00019
  3. Kirtsreesakul V, Tuntaraworasin J, Thamjarungwong B. Microbiology and antimicrobial susceptibility patterns of commensal flora in the middle nasal meatus. Ann Otol Rhinol Laryngol 2008;117:914-8. https://doi.org/10.1177/000348940811701209
  4. Breda SD, Jacobs JB, Lebowitz AS, et al. Toxic shock syndrome in nasal surgery: a physiochemical and microbiologic evaluation of Merocel and NuGauze nasal packing. Laryngoscope 1987;97:1388-91.
  5. Kremer B, Jacobs JA, Soudijn ER, et al. Clinical value of bacteriological examinations of nasal and paranasal mucosa in patients with chronic sinusitis. Eur Arch Otorhinolaryngol 2001;258:220-5. https://doi.org/10.1007/s004050100342
  6. Perl TM, Golub JE. New approaches to reduce Staphylococcus aureus nosocomial infection rates: treating S. aureus nasal carriage. Ann Pharmacother 1998;32:S7-16. https://doi.org/10.1177/106002809803200104
  7. Whymark AD, Crampsey DP, Fraser L, et al. Childhood epistaxis and nasal colonization with Staphylococcus aureus. Otolaryngol Head Neck Surg 2008;138:307-10. https://doi.org/10.1016/j.otohns.2007.10.029
  8. Koc S, Uysal IO, Uysal EB, et al. The comparison of bacteremia and amount of bleeding during septoplasty. Eur Arch Otorhinolaryngol 2012;269:1139-42. https://doi.org/10.1007/s00405-011-1789-2
  9. Huebner J, Goldmann DA. Coagulase-negative staphylococci: role as pathogens. Annu Rev Med 1999;50:223-36. https://doi.org/10.1146/annurev.med.50.1.223
  10. Barbier F, Ruppe E, Hernandez D, et al. Methicillin-resistant coagulase-negative staphylococci in the community: high homology of SCCmec IVa between Staphylococcus epidermidis and major clones of methicillin-resistant Staphylococcus aureus. J Infect Dis 2010;202:270-81. https://doi.org/10.1086/653483
  11. Rohrich RJ, Adams WP Jr. Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 2000;106:266-73. https://doi.org/10.1097/00006534-200008000-00003
  12. Savolainen S, Ylikoski J, Jousimies-Somer H. The bacterial flora of the nasal cavity in healthy young men. Rhinology 1986;24:249-55.
  13. von Eiff C, Becker K, Machka K, et al. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med 2001;344:11-6. https://doi.org/10.1056/NEJM200101043440102
  14. Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10: 505-20.
  15. Kuehnert MJ, Kruszon-Moran D, Hill HA, et al. Prevalence of Staphylococcus aureus nasal colonization in the United States, 2001-2002. J Infect Dis 2006;193:172-9. https://doi.org/10.1086/499632
  16. Kim HB, Shin DH, Park KU, et al. The methicillin-resistance rate of Staphylococcus aureus isolatd from anterior nares of healthy adults in the community. Korean J Infect Dis 1998; 30:527-31.
  17. Versalovic J, American Society for Microbiology. Manual of clinical microbiology. 10th ed. Washington, DC: American Society for Microbiology; 2011.
  18. Otto M. Coagulase-negative staphylococci as reservoirs of genes facilitating MRSA infection: Staphylococcal commensal species such as Staphylococcus epidermidis are being recognized as important sources of genes promoting MRSA colonization and virulence. Bioessays 2013;35:4-11. https://doi.org/10.1002/bies.201200112
  19. Cochran CS, Landecker A. Prevention and management of rhinoplasty complications. Plast Reconstr Surg 2008;122: 60e-7e. https://doi.org/10.1097/PRS.0b013e31817d53de
  20. Perl TM. Prevention of Staphylococcus aureus infections among surgical patients: beyond traditional perioperative prophylaxis. Surgery 2003;134:S10-7. https://doi.org/10.1016/S0039-6060(03)00391-X
  21. Angelos PC, Wang TD. Methicillin-resistant Staphylococcus aureus infection in septorhinoplasty. Laryngoscope 2010; 120:1309-11. https://doi.org/10.1002/lary.20966
  22. van Rijen M, Bonten M, Wenzel R, et al. Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. Cochrane Database Syst Rev 2008;(4): CD006216.
  23. Rajan GP, Fergie N, Fischer U, et al. Antibiotic prophylaxis in septorhinoplasty? A prospective, randomized study. Plast Reconstr Surg 2005;116:1995-8. https://doi.org/10.1097/01.prs.0000191181.73298.b3
  24. Gocer C, Dursun E, Acar A, et al. Antimicrobial prophylaxis in nasoseptal surgery [Internet]. Ankara: KBB-Forum; 2007 [cited 2013 Aug 28]. Available from: http://www.kbbforum.net/journal/pdf/pdf_KBB_170.pdf.

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