Characterizing Bacterial Colonization in Pilonidal Sinus Abscesses: Insights from 159 Clinical Evaluations

Abstract

Objective: This study aimed to evaluate the gender predisposition, risk factors, clinical outcomes, and microbiological profile of patients with pilonidal sinus disease (PSD) and to compare these findings with existing literature. Materials and Methods: A prospective analysis was conducted on 159 patients diagnosed with PSD at Haydarpasa Numune Hospital between 2022 and 2023. Demographic data, BMI, smoking status, presence of diabetes, and treatment outcomes were collected. Pathogens isolated from abscesses and antibiotic treatments were analyzed, and recurrence rates were documented post-treatment. Results: The study cohort had a mean age of 26.0±9.8 years, predominantly male (71.1%). Significant differences in mean age and body mass index were observed between females (n=46) and males (n=113), with females averaging 21.6 years and males 27.8 years (p<0.001), and BMI values of 22.06 and 24.33, respectively (p=0.003). Anaerobic bacteria were slightly more prevalent in abscess cultures (50.9%), and the most commonly used antibiotic regimen was ciprofloxacin with metronidazole (54.7%). Conclusion: This study confirms a male gender predisposition to PSD and highlights significant age and BMI differences between genders. Specific antibiotic therapies may contribute to reducing relapse rates. These findings underscore the importance of targeted therapeutic strategies, particularly considering the higher recurrence rates in females and the predominant antibiotic resistance patterns.