Microbiological and Molecular Study of Paranasal Sinus Infections of Children with Malignancy and Unknown Origin Fever in Markazi Province, Iran

Kazem Ghaffari; Vahid Falahati; Tahereh Motallebirad; Mahdi Safarabadi; Amir Hossein Tashakor; Davood Azadi

doi:10.1016/j.curtheres.2024.100745

Microbiological and Molecular Study of Paranasal Sinus Infections of Children with Malignancy and Unknown Origin Fever in Markazi Province, Iran

Curr Ther Res Clin Exp. 2024 Mar 19:100:100745. doi: 10.1016/j.curtheres.2024.100745. eCollection 2024.

Authors

Kazem Ghaffari^{1

2}, Vahid Falahati³, Tahereh Motallebirad¹, Mahdi Safarabadi⁴, Amir Hossein Tashakor⁵, Davood Azadi¹

Affiliations

¹ Department of Basic Sciences, Khomein University of Medical Sciences, Khomein, Iran.
² Student Research Comittee, Khomein University Of Medical Sciences, Khomein, Iran.
³ Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran.
⁴ Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran.
⁵ Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Children with malignancies are vulnerable to various infections, including sinus infections. Sinusitis is primarily caused by bacterial infections, followed by fungal infections. Due to this, evaluating the occurrence, diversity, and antibiotic susceptibility patterns of bacterial species that cause paranasal sinus infections in children with malignancy and unexplained fever is important.

Objective: To investigate the bacterial species accountable for sinusitis in children with malignancy and unexplained fever, and determine their susceptibility to antibiotics.

Methods: The study involved collecting 90 sinus samples from children aged 5 to 15 years with malignancy in Arak City, Iran. The isolates were identified using a combination of phenotypic, biochemical, and molecular techniques, including specific polymerase chain reaction and 16S ribosomal RNA gene sequencing. Drug susceptibility testing was performed following the Clinical & Laboratory Standards Institute 2021 guidelines.

Results: A total of 36 isolates (40%) were obtained, including 4 isolates of Nocardia (11.12%), 4 isolates of Escherichia coli (11.12%), 3 isolates of Klebsiella pneumoniae (8.33%), 5 isolates of Pseudomonas aeruginosa (13.88%), 3 isolates of Acinetobacter baumannii (8.33%), 4 isolates of Staphylococcus aureus (11.12%), 3 isolates of Staphylococcus epidermidis (8.33%), 5 isolates of Streptococcus agalactiae (13.88%), 2 isolates of Streptococcus pneumoniae (5.55%), and 3 isolates of Enterococcus faecium (8.33%). The isolates showed the most sensitivity to imipenem and trimethoprim-sulfamethoxazole and the least sensitivity to erythromycin and tetracycline.

Conclusions: The findings of the study indicate that sinusitis can contribute to fever of unknown origin in patients with cancer. Therefore, it is recommended to use a combination of molecular and phenotypic methods for accurate identification of isolates. This approach can provide more reliable and precise results, leading to better diagnosis and treatment of sinusitis infections in children with malignancy.

Keywords: 16S rRNA; Malignancy; Unknown origin fever.