Key points are not available for this paper at this time.
Introduction This study aimed to elucidate the bacterial profile of chronic rhinosinusitis (CRS) in patients with end‐stage renal disease (ESRD) and chronic kidney disease (CKD) compared with nonrenal patients, guiding antibiotic selection for clinicians. Methods We retrospectively analyzed 13,906 inpatients from the Chang Gung Research Database who underwent sinus surgery (2004–2018). Patients were categorized into ESRD‐CRS, CKD‐CRS, and non‐CKD‐CRS based on the estimated glomerular filtration rate. Bacterial cultures from surgical samples were classified as facultative anaerobes or aerobes (e.g., Klebsiella pneumoniae KP, Pseudomonas aeruginosa Ps.a), anaerobes, and fungi and ranked by prevalence. Results Data from 47 ESRD‐CRS, 230 CKD‐CRS, and 13,123 non‐CKD‐CRS patients were analyzed. In ESRD‐CRS, the predominant species were KP (31.6%), Ps.a (21.1%), and Coagulase‐negative Staphylococcus (CoNS, 15.8%). CKD‐CRS showed Staphylococcus epidermidis (27.7%), CoNS (20.5%), and Ps.a (20.5%). Non‐CKD‐CRS had Staphylococcus epidermidis (29.8%), CoNS (25.0%), and Staphylococcus aureus (15.5%). For anaerobes, ESRD‐CRS was dominated by Fusobacterium nucleatum (10.5%) and Peptostreptococcus micros (10.5%), whereas CKD‐CRS and non‐CKD‐CRS showed Propionibacterium acnes as a primary strain (14.5% and 28.7%, respectively). Conclusion For CRS in ESRD, antibiotics targeting KP and Fusobacterium nucleatum are recommended. In CKD‐CRS, a focus on Staphylococcus epidermidis and Propionibacterium acnes is suggested. Level of Evidence 4 Laryngoscope , 134:3499–3507, 2024
Lo et al. (Sat,) studied this question.