Journal Article

Nosocomial Sinusitis in Patients in the Medical Intensive Care Unit: A Prospective Epidemiological Study

David L. George, Pamela S. Falk, G. Umberto Meduri, Kenneth V. Leeper, Richard G. Wunderink, Elaine L. Steere, F. Kent Nunnally, Neal Beckford and C. Glen Mayhall

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 3, pages 463-470
Published in print September 1998 | ISSN: 1058-4838
Published online September 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514711
Nosocomial Sinusitis in Patients in the Medical Intensive Care Unit: A Prospective Epidemiological Study

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A prospective observational cohort study of nosocomial sinusitis was carried out in two medical intensive care units. Sinusitis was diagnosed by computed tomographic scanning and the culture of sinus fluid obtained by puncture of a maxillary sinus. Clinical and epidemiological data were collected at the time of admission to the unit and daily thereafter. Specimens from the nares, oropharynx, trachea, and stomach were cultured on admission and daily thereafter. The cumulative incidence of nosocomial sinusitis was 7.7%, and the incidence rates were 12 cases per 1,000 patient-days and 19.8 cases per 1,000 nasoenteric tube-days. Risk factors for nosocomial sinusitis, as determined by multiple logistic regression analysis, included nasal colonization with enteric gram-negative bacilli (odds ratio [OR], 6.4; 95% confidence interval [95% CI], 2.2–18.8; P = .007), feeding via nasoenteric tube (OR, 14.1; 95% CI, 1.7–117.6; P = .015), sedation (OR, 15.9; 95% CI, 1.9–133.5; P = .011), and a Glasgow coma score of ⩽7 (OR, 9.1; 95% CI, 3.0–27.3; P = .0001).

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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