caa a22 4500 477070086 CHVBK 20180405111422.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/BF01709360 doi (NATIONALLICENCE)springer-10.1007/BF01709360 Sinusitis in mechanically ventilated patients and its role in the pathogenesis of nosocomial pneumonia [Elektronische Daten] [F. Bert, N. Lambert-Zechovsky] Nosocomial sinusitis is a complication of endotracheal intubation and mechanical ventilation in critically ill patients. Its incidence is often underestimated because of a lack of clinical signs. It is suspected in patients with nasal discharge or unexplained fever. Its diagnosis is based on radiological examination, by radiograph or computed tomography scan, and microbiological cultures of maxillary sinus aspirate. Maxillary sinusitis is often associated with involvement of the sphenoid, ethmoid, and/or frontal sinuses. Its incidence varies greatly according to diagnostic criteria and the population studied. Infectious sinusitis is less frequent than noninfectious sinusitis, occurring in 20 to 30% of patients intubated for at least seven days. Its incidence is higher in nasotracheally than in orotracheally intubated patients. Other risk factors include nasogastric tubes and head trauma. The main causative agents are gram-negative bacilli, primarilyPseudomonas aeruginosa, Acinetobacter baumannii, andEnterobacteriaceae, butStaphylococcus aureus and yeasts are also common. Patients with nosocomial sinusitis are more likely to develop pneumonia than those without sinusitis. The sinus provides a bacterial reservoir from which organisms may seed the tracheobronchial tree. The association of sinusitis and pneumonia is mainly due toStaphylococcus aureus, Pseudomonas aeruginosa, andAcinetobacter baumannii. The treatment of sinusitis is based on the removal of all nasal tubes, topical decongestants, and maxillary sinus drainage and lavage. The role of intravenous antibiotics is controversial. MMV Medizin Verlag GmbH, 1996 Bert F. Service de Microbiologie, Hôpital Beaujon, 100 boulevard du Général Leclerc, 92110, Clichy, France aut Lambert-Zechovsky N. Service de Microbiologie, Hôpital Beaujon, 100 boulevard du Général Leclerc, 92110, Clichy, France aut European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/7(1996-07-01), 533-544 0934-9723 15:7<533 1996 15 10096 https://doi.org/10.1007/BF01709360 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01709360 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bert F. Service de Microbiologie, Hôpital Beaujon, 100 boulevard du Général Leclerc, 92110, Clichy, France aut NATIONALLICENCE 700 1- Lambert-Zechovsky N. Service de Microbiologie, Hôpital Beaujon, 100 boulevard du Général Leclerc, 92110, Clichy, France aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/7(1996-07-01), 533-544 0934-9723 15:7<533 1996 15 10096 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer