Objectif - Evaluer la frequence d'isolement des bacteries anaerobies strictes au cours des sinusites diagnostiquees en milieu hospitalier. Materiel et methode - Une etude retrospective sur une duree de 17 mois, de decembre 1997 a avril 1999 a porte sur 171 prelevements realises chez 127 malades. Ces malades etaient divises en deux groupes : groupe I constitue de 70 patients des services d'ORL et medecine et groupe II constitue de 57 malades sous ventilation assistee des services de reanimations medicale et chirurgicale. Les prelevements ont ete realises par ponction ou par ecouvillonnage au niveau du meat moyen et rapidement ensemences. Resultats - La culture etait plus souvent positive chez les patients intubes de reanimation : 87,7 % des malades du groupe II versus 67 % dans le groupe I (p = 0,006). Les bacteries aerobies ou aeroanaerobies facultatives, en particulier Pseudomonas aeruginosa, Staphylococcus aureus et les enterobacteries etaient isolees plus souvent dans le groupe II (80,7 %) que dans le groupe I (52,9 %) (p = 0,001) ainsi que les bacteries anaerobies strictes : 50,9 % versus 32,9 % (p = 0,038). Ces bacteries anaerobies etaient principalement des bacilles a Gram negatif des genres Prevotella et Fusobacterium. Aucune des souches de Fusobacterium mais 76,9 % des 39 souches de Prevotella etaient productrices de betalactamase. Les principales especes isolees : P. intermedia et F. nucleatum possedent des facteurs de virulence etablis suggerant un role pathogene propre a ces bacteries.
Objective - The purpose of this study was to assess the frequency of strictly anaerobic bacteria in patients with sinusitis, particularly in mechanically ventilated patients. Method - A retrospective study was carried out over a 17-month period from December 1997 to April 1999. One hundred and seventy-one samples were analysed from 127 patients. They were divided into two groups: group I with 70 patients from otorhinolaryngology and medicine units, and group II with 57 patients from intensive care units. These latter patients were mechanically ventilated. Samples were obtained either by puncture or by swabbing through the sinus ostium and rapidly inoculated in an anaerobic atmopshere. Results - Bacterial growth was present more often from the ventilated patients: 87.7% in group II vs 67% in group I (P = 0.006). The aerobic and facultative anaerobic bacteria, in particular Pseudomonas aeruginosa, Staphylococcus aureus and Enterobacteria, were also more frequently isolated in group II: 80.7% vs 52.9% (P = 0.001), as well as anaerobes: 50.9% vs 32.9% (P = 0.038). No Fusobacterium but 76.9% among 39 strains of Prevotella produced beta-lactamase. Anaerobic bacteria were mainly Gram-negative rods from the genera Prevotella and Fusobacterium. The main isolated species, P. intermedia and F. nucleatum, are known to have virulent factors, suggesting a specific pathogenic role.