Comparative Evaluation of PCR and Conventional Culture Techniques in Detecting Bacterial Pathogens in Sinus Infections: A Prospective Study

Abstract

Background: Sinus infections, or rhinosinusitis, are a significant public health concern, with bacterial pathogens such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis playing a major role in acute bacterial sinusitis (ABS). The accurate and timely detection of these pathogens is crucial for effective management and antibiotic stewardship. Conventional culture techniques, though widely used, have limitations in sensitivity and turnaround time. Polymerase Chain Reaction (PCR) has emerged as a promising molecular diagnostic tool with higher sensitivity and faster results.
Objective: This study aims to compare the effectiveness of PCR and conventional culture techniques in detecting bacterial pathogens in sinus infections, focusing on sensitivity, specificity, and turnaround time.
Methods: A prospective study was conducted over 12 months across three tertiary care hospitals in Central India. Clinical samples (nasal swabs and sinus aspirates) were collected from 500 patients, with 470 adequate samples analyzed using both culture and PCR methods. Culture identification was performed using standard biochemical techniques, while PCR targeted bacterial 16S rRNA genes for S. pneumoniae, H. influenzae, and M. catarrhalis.
Results: Bacterial pathogens were detected in 58.5% of cases using culture and in 87.6% using PCR. S. pneumoniae was the most common pathogen (45.2%), followed by H. influenzae (32.8%) and M. catarrhalis (21.4%). PCR demonstrated significantly higher sensitivity (96.3%) compared to culture (63.8%), while specificity remained high for both techniques (PCR: 98.7%, Culture: 100%). PCR also provided a much shorter turnaround time (6–8 hours) compared to culture (24–72 hours), facilitating early diagnosis and targeted therapy.
Conclusion: PCR is a highly sensitive and rapid diagnostic tool for detecting bacterial pathogens in sinus infections, outperforming conventional culture methods. However, culture remains essential for antibiotic susceptibility testing. The integration of molecular diagnostics with traditional methods could optimize patient management and antimicrobial stewardship in clinical settings.