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    Effects of endoscopic endonasal sinus surgery on nasal flora in patients with chronic rhinosinusitis with nasal polyps
    (2019) Ulusoy, Bulent; Ersoy Callioglu, Elif; Muderris, Tuba; Bozdemir, Kazim; Oguzhan, Tolga; Kutluhan, Ahmet; Acikgoz, Ziya Cibali; Korkmaz, Mehmet Hakan
    Aim: This study aimed to evaluate the alterations in the nasal flora in patients who underwent endoscopic endonasal surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Material and Methods: This prospective study included 30 patients diagnosed with CRSwNP who were resistant to medical treatment and recommended for surgery. The nasal cavity was sampled two times, first preoperatively on the day of operation and postoperatively in the 4th week. Patients were divided into two groups according to their culture results, including normal flora bacteria and potential pathogen production. Results: In the preoperative swab samples, 3 (11.1%) patients had no bacterial growth, 16 (59.3%) patients had a normal flora, and potential pathogens were detected in 8 (29.6%) patients. However, postoperatively, 3 (11.1%) patients had no bacterial growth, 13 (48.1%) patients had a normal flora, and potential pathogens were detected in 11 (40.7%) patients during the postoperative period. No significant difference was found between preoperative and postoperative culture results in terms of the number of patients with normal flora, potential pathogens, and no bacterial growth (p=0.676). The most common microorganism in the normal flora group preoperative and postoperative period was coagulase-negative Staphylococcus (77.8%, 51.9%, respectively), and the most common microorganism in the potential pathogen group was Staphylococcus aureus (18.5% and 25.9%, respectively). Comparing preoperative and postoperative culture results according to isolated potential pathogen microorganism types, no statistically significant difference was observed for any microorganism in the potential pathogen group (p>0.05).Conclusion: As a result, no correlation between nasal polyps’ surgery and potential pathogens was detected. Keywords: Chronic rhinosinusitis; culture; nasal polyps; flora; potential pathogens; bacteria; Staphylococcus aureus; coagulase; transnasal endoscopic surgery; pseodomanas.
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    Microorganisms isolated from external ear cultures and their antimicrobial susceptibility in patients with chronic suppurative otitis media: A six years experience
    (2020) Balci, Mustafa Koray; Ozdemir, Rahim; Muderris, Tuba; Gul Yurtsever, Sureyya; Kaya, Selcuk
    Aim: Chronic suppurative otitis media (CSOM) continues to be a major health issue in developing countries. The goal of this study was to establish the microorganisms causing CSOM and their susceptibility to antimicrobials.Materials and Methods: External ear tract swab that came to our laboratory between 2014-2019 were evaluated retrospectively. The data were obtained from the hospital medical records. Data was collected using an electronic database. Results: The analysis included 185 ear swab samples. These patients 55.1% male and 44.9% female, and average age was 44.29 ± 1.6 (2-86) years. Forty (21.6%) of the patients included in the study were diagnosed with cholesteatoma as having chronic suppurative otitis media. The first three bacteria species isolated from the samples included in the study; Pseudomonas aeruginosa (31.9%), Staphylococcus aureus (11.9%) and Escherichia coli (9.7%). In addition, in 10.8% of the samples Candida spp. and in 5.4% of the samples Aspergillus spp. were isolated. The first three species isolated from the patients with cholesteatoma; P. aeruginosa (6.5%),S. aureus (4.3%) and Candida spp. (3.2%), the first three species isolated in patients without cholesteatoma; P. aeruginosa (25.4%), E. coli (8.1%), S. aureus and Candida spp. (7.6%) was detected. Ciprofloxacin (68.8%) and gentamicin (46.7%) in P. aureginosa isolates, amoxicillin-clavulonic acid (66.7%) and trimethoprim-sulfamethoxazole (42.9%) in E. coli isolates were found to be the most resistant antimicrobials.Conclusion: In conclusion, antimicrobial therapy should not be initiated in CSOM patients without waiting for the culture result. However, in cases where empirical antimicrobial therapy is mandatory, the first choice has been determined as amikacin. Good awareness of microorganisms’ antimicrobial sensitivity can lead to appropriate antibiotic usage and treatment success for CSOM. We think that multicenter prospective studies are needed to organize effective treatments of these infections.