© Borgis - New Medicine 3/1999, s. 48-49
Krystyna Orendorz-Frączkowska, Marek Bochnia
Microbiological examination in children with chronic tonsillitis
Department of Otolaryngology, Medical Academy, Wrocław
Head: Prof. Lucyna Pośpiech, M.D.
Chronic tonsillitis is the most common indication for tonsillectomy. It is often caused by an inappropriate antibiotic therapy for acute tonsillitis. Thus, it is very important to be conversant with the bacteriology of respiratory tract infections.
30 children aged (4.5-17) with chronic tonsillitis were included in the study. The purpose was microbiologic assessment of swabs taken from the surface and inside of the tonsils. 19 gram+ and gram- bacteria strains were isolated from all swabs. Str. Orale, Peptostr. Spp. and Neisseria spp. were present in all patients on the surface and inside tonsils. St. Aureus was identified as the causative factor of chronic tonsillitis in 14 children (46.2%). Str. Pyogenes type A in 12 (40.6%), E. coli in 2 (6.6%) and Klebsiella xytoca in 2 (6 6%). Among these St. Aureus and Str. Pyogenes type A were the most common (86. 6%).
Numerous saprophyte and relative or evident pathogens are present in the upper respiratory tract, either periodically or constantly. As a result of many health conditions, e.g. viral infection, an organism may become susceptible to bacterial infection. One of these conditions, especially common in childhood, is the recurrence of acute tonsillitis. If treatment does not eradicate the invading bacteria a child may subseqquently develop chronic tonsillitis. Because of its mutability, a knowledge of normal tonsillar flora is then necessary to condition the proper use of antimicrobial therapy. The aim of our study was to examine swabs taken from the surface and from the inside of tonsils. The material consisted of children suffering from chronic tonsillitis and qualified for tonsillectomy.
Material and methods
30 children aged 4.5 to 17 (average 10), qualified for tonsillectomy because of chronic tonsillitis, were examined. All of them were treated at the Polyclinic because of recurrent acute tonsillitis. The children were not administered antibiotics for longer than 3-4 weeks before the surgical intervention. In each case 4 swabs, 2 from the surface and 2 from the inside of each tonsil were taken during tonsillectomy. Swabs were placed in test-tubes with a transport medium suitable for aerobic and anaerobic bacteria. The material was sent immediately to a microbiological laboratory. Inoculation, identification and estimation of the resistance and sensitiveness to antibiotics were carried out according to standard procedures.
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