Methicillin-Resistant Infections in the Sinus Cavity Guide for Patients

Methicillin-resistant infections in the sinus cavity is a bacterial infection. This infection tends to be highly resistant to certain antibiotics. It is estimated that approximately 25 to 30 percent of people have this type of bacteria in their nose or on their skin. However, unless it gets into the body, such as through a scratch, infection usually does not occur. This type of infection is most commonly referred to as MRSA and it is a staph infection that affects the sinus cavity.

Diagnosis

When the patients arrives at her appointment her doctor will ask her about her symptoms. He will then obtain a sample of her nasal secretions and have them examined for the signs of drug-resistant bacteria. The patient's doctor may also obtain a sputum culture. This is done by having the patient cough deeply and them spit any sputum they drag up into a sterile cup. This sample is then sent for further analysis. Other diagnostic tests that may be done include a urine culture and a blood culture.

Treatment

While methicillin-resistant infections in the sinus cavity can be difficult to treat, there are things that can be done. Doctors will often begin by using topical treatments. Such treatments may include:

  • Directly injecting cortisporin ointment or Bactroban cream into the sinus cavity
  • Using chemical saline flushes in the patient's sinus cavity
  • Saline flushes
  • Antibiotic flushes to the patient's sinus cavity

Some antibiotics may still be effective in treating this infection. Such antibiotics may include:

  • Clindamycin
  • Doxycycline
  • Minocycline
  • Trimethoprim-sulfamethoxazole
  • Daptomycin
  • Linezolid
  • Tetracycline
  • Vancomycin

If antibiotics are administered patients must complete all doses for them to be most effective. If the entire course is not completed, further drug resistance, infection recurrence, or the infection not being completely treated may occur.

If the patient's infection is severe, sinus surgery may be done for the following reasons:

  • To surgically clean out the infection (similar to how draining a skin abscess is done)
  • So that any future sinus infections can be more carefully followed with endoscopy
  • To enlarge the sinus cavity openings so that post-op topical treatment is easier to help possibly avoid IV and oral antibiotics

After sinus surgery, if it is necessary, sinus cavity debridement can often be easily performed in the doctor's office.

Prevention

There are ways to prevent this infection. First, patients and health care professionals should make sure they carefully and frequently wash their hands. Using hand-sanitizer that is at least 60 percent alcohol is also beneficial. Keeping all wounds properly covered and not sharing personal items, especially hygiene items, will also help to prevent this infection. Keeping all linens sanitized through washing them in the hottest water possible and drying them in a hot dryer is helpful. Also, use bleach to wash linens when possible (ensure the items cannot be damaged by bleach first). After athletic games, shower right away and do not share hygiene items or towels.

Resources

Pakistan Journal of Medical Sciences Quarterly. (2009). The Prevalence of Nasal Carriage Methicillin-Resistant Staphylococcus Aureus in Hospitalized Patients. Retrieved on December 22, 2010 from the Pakistan Journal of Medical Sciences Quarterly: https://pjms.com.pk/issues/julsep09/article/article25.html

MedlinePlus. (2009). MRSA. Retrieved on December 22, 2010 from MedlinePlus: https://www.nlm.nih.gov/medlineplus/ency/article/007261.htm