A comparative microbiological study of surface, aspirate and core tonsillar flora in chronic tonsillitis

  • Dr. Sriram Govindaraj Assistant Professor, Vinayaka Missions Medical College and Hospital Karaikal, Puducherry, India
  • Dr. Ganeshbala Arivazhagan Professor, Vinayaka Missions Medical College and Hospital Karaikal, Puducherry, India
  • Dr. Swetha Lakshmi M. Postgraduate, Vinayaka Missions Medical College and Hospital Karaikal, Puducherry, India
  • Dr. Jayendiran S. Senior Resident, Vinayaka Missions Medical College and Hospital Karaikal, Puducherry, India
Keywords: Chronic tonsillitis, Bacteriological profile, Antibiogram, Tonsillectomy

Abstract

Background: Chronic tonsillitis is most common condition which affects school going children. Improper use of antibiotic among the common population has led to many drug resistant organisms; therefore, it is necessary to study the antimicrobial susceptibility pattern before treating the patient with Chronic tonsillitis. Aim of the study is to determine whether fine-needle aspiration of tonsil, gives a representative picture of deep tonsil flora in chronic tonsillitis, as assessed by subsequent culture from the core of the resected tonsils, and to compare the findings of fine needle tonsils aspiration, with findings from a routine superficial tonsil surface swab.

Methods: Study conducted at ENT department of Vinayaka mission medical college, Karaikal, Pondicherry over a period of 1year (June 2018 to May 2019). 77 patients were operated for chronic tonsillitis were included in the study. 3 swabs were collected from surface of tonsil. Tonsil aspiration was done using a 10-mL syringe with an18-gauge needle and swab from core of tonsil was collected for culture and sensitivity. Bacterial isolates were identified using standard methods and antibiotic susceptibility testing were done.

Results: Group B hemolytic streptococcus, Streptococcus pneumonae and Staphlococcus aueus were the predominant microbes isolated in the aspirate and tonsil core tissue in outpatient population. Whereas Alpha hemolytic streptoccus and Group B hemolytic streptococcus were predominantly seen in tonsillar surface.

Conclusions: Tonsil fine needle aspiration helps in diagnosis of Chronic tonsillitis and culture based antibiotic therapy. Due to which Tonsillectomy procedures can be avoided in Chronic tonsillitis patients.

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References

Kalaiarasi R, Subramanian KS, Vijayakumar C, Venkataramanan R. Microbiological Profile of Chronic Tonsillitis in the Pediatric Age Group. Cureus. 2018;10 (9): e3343. doi: https://dx.doi.org/10.7759%2Fcureus.3343.

Jović M, Avramović V, Vlahović P, Veličkov A, Petrović V. Expression of CD34 and CD146 vascular markers contributes to the immunological function of the human palatine tonsil.Histology and histopathology. 2018; 33(3):261-268. doi: https://doi.org/10.14670/HH-11-919

Parker NP, Walner DL. Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediat Otorhinolaryngol. 2011;75(2):282-285. doi: https://doi.org/10.1016/j.ijporl.2010.11.019. Epub 2010 Dec 18.

Brook I, Yocum P. Bacteriology of chronic tonsillitis in young adults. Arch Otolaryngol. 1984;110(12):803-805. doi: https://doi.org/10.1001/archotol.1984.00800380033009

Surow JB, Handler SD, Telian SA, Fleisher GR, Baranak CC. Bacteriology of tonsil surface and core in children.Laryngoscope. 1989; 99(3): 261-266. doi: https://doi.org/10.1288/00005537-198903000-00005

Rosen G, Samuel J, Vered I. Surface tonsillar microflora versus deep tonsillar microflora in recurrent acute tonsillitis. J Laryngol Otol. 1977;91(10):911-913. doi: https://doi.org/10.1017/S0022215100084553

Gastanaduy AS, Kaplan EL, Huwe BB, McKay C, Wannamaker LW. Failure of penicillin to eradicate group A streptococci during an outbreak of pharyngitis. Lancet. 1980;2(8193):498-502. doi: https://doi.org/10.1016/S0140-6736(80)91832-22

Brook I. The role of β-lactamase-producing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect dis. 1984;6(5):601-607.

Timon CI, Cafferkey MT, Walsh M. Fine-needle aspiration in recurrent tonsillitis. Arch Otolaryngol–Head & Neck Surg. 1991;117(6):653-656. doi: https://doi.org/10.1001/archotol.1991.01870180089017

Everett MT. The cause of tonsillitis. Practitioner. 1979;223(1334):253-259.

Scheifele DW, Fussell SJ. Ampicillin-resistant Haemophilus influenzae colonizing ambulatory children: Epidemiology and implications for otitis media therapy.Am J Dis Child.1981;135(5):406- 409

Brook I, Gober AE. Emergence of Beta-lactamase-prod uci ng Aerobic and Anaerobic Bacteria in the Oropharynx of Children Following Penicillin Chemotherapy. Clinic Pediatr. 1984; 23(6):338-341. doi: https://doi.org/10.1001/archotol.1991.01870180089017

Surow JB, Handler SD, Telian SA, Fleisher GR, Baranak CC. Bacteriology of tonsil surface and core in children. Laryngoscope. 1989;99(3): 261-266. doi:10.1288/00005537-198903000-00005

DeDio RM, Tom LW, McGowan KL, Wetmore RF, Handler SD, Potsic WP. Microbiology of the tonsils and adenoids in a pediatric population. Arch Otolaryngol Head Neck Surg. 1988; 114(7):763-5. doi: https://doi.org/10.1001/archotol.1988.01860190067025

Brodsky L, Moore L, Stanievich J. The role of Haemophilus influenzae in the pathogenesis of tonsillar hypertrophy in children. The Laryngoscope. 1988;98 (10): 1055-1060.

Agrawal A, Kumar D, Goyal A, Gupta R, Bhooshan S. Bacteriological evaluation and their antibiotic sensitivity pattern in tonsillitis. IOSR J Dental Med Sc. 2014;13(3):51-55.

Kielmovitch IH, Keleti G, Bluestone CD, Wald ER, Gonzalez C. Microbiology of obstructive tonsillar hypertrophy and recurrent tonsillitis. Arch Otolaryngol Head Neck Surg. 1989;115(6):721-724. doi: https://doi.org/10.1001/archotol.1989.01860300075021

Develioglu ON, Ipek HD, Bahar H, Can G, Kulekci M, Aygun G. Bacteriological evaluation of tonsillar microbial flora according to age and tonsillar size in recurrent tonsillitis. Eur Arch Otorhinolaryngol. 2014; 271(6):1661-1665. doi: https://doi.org/10.1007/s00405-014-2898-5. Epub 2014 Feb 1.

CITATION
DOI: 10.17511/jooo.2019.i05.03
Published: 2019-10-19
How to Cite
Govindaraj, S., Arivazhagan, G., Lakshmi M., S., & S., J. (2019). A comparative microbiological study of surface, aspirate and core tonsillar flora in chronic tonsillitis. Tropical Journal of Ophthalmology and Otolaryngology, 4(5), 320-327. https://doi.org/10.17511/jooo.2019.i05.03
Section
Original Article