Comparison of endoscopically-guided swab vs aspirate culture techniques in post-endoscopic sinus surgery patients: Blinded, prospective analysis

Evan Walgama, Thunchai Thanasumpun, Rita Gander, Pete S. Batra

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Results: 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 (p = 0.0032). The prevalence of Pseudomonas aeruginosa was 42% for aspirate vs 30% for swab cultures, respectively. The prevalence of Staphylococcus aureus 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. Conclusion: This prospective analysis demonstrated higher culture yield, particularly with Pseudomonas, 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.

Original languageEnglish (US)
Pages (from-to)726-730
Number of pages5
JournalInternational Forum of Allergy and Rhinology
Volume3
Issue number9
DOIs
StatePublished - Sep 2013

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Culture Techniques
Suction
Tertiary Healthcare
Pseudomonas
Pseudomonas aeruginosa
Endoscopy
Staphylococcus aureus
Therapeutics
Anti-Bacterial Agents

Keywords

  • Aspirate
  • Chronic sinusitis
  • Culture
  • Endoscopy
  • Microbiology
  • Swab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Comparison of endoscopically-guided swab vs aspirate culture techniques in post-endoscopic sinus surgery patients : Blinded, prospective analysis. / Walgama, Evan; Thanasumpun, Thunchai; Gander, Rita; Batra, Pete S.

In: International Forum of Allergy and Rhinology, Vol. 3, No. 9, 09.2013, p. 726-730.

Research output: Contribution to journalArticle

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abstract = "Background: 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. Methods: 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. Results: 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 (p = 0.0032). The prevalence of Pseudomonas aeruginosa was 42{\%} for aspirate vs 30{\%} for swab cultures, respectively. The prevalence of Staphylococcus aureus 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. Conclusion: This prospective analysis demonstrated higher culture yield, particularly with Pseudomonas, 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.",
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