Adenoid Reservoir for Pathogenic Biofilm Bacteria

Abstract

Biofilms of pathogenic bacteria are present on the middle ear mucosa of children with chronic otitis media (COM) and may contribute to the persistence of pathogens and the recalcitrance of COM to antibiotic treatment. Controlled studies indicate that adenoidectomy is effective in the treatment of COM, suggesting that the adenoids may act as a reservoir for COM pathogens. To investigate the bacterial community in the adenoid, samples were obtained from 35 children undergoing adenoidectomy for chronic OM or obstructive sleep apnea. We used a novel, culture-independent molecular diagnostic methodology, followed by confocal microscopy, to investigate the in situ distribution and organization of pathogens in the adenoids to determine whether pathogenic bacteria exhibited criteria characteristic of biofilms. The Ibis T5000 Universal Biosensor System was used to interrogate the extent of the microbial diversity within adenoid biopsy specimens. Using a suite of 16 broad-range bacterial primers, we demonstrated that adenoids from both diagnostic groups were colonized with polymicrobial biofilms. Haemophilus influenzae was present in more adenoids from the COM group (P ‫؍‬ 0.005), but there was no significant difference between the two patient groups for Streptococcus pneumoniae or Staphylococcus aureus. Fluorescence in situ hybridization, lectin binding, and the use of antibodies specific for host epithelial cells demonstrated that pathogens were aggregated, surrounded by a carbohydrate matrix, and localized on and within the epithelial cell surface, which is consistent with criteria for bacterial biofilms.

Adenoidectomy: current approaches and review of the literature

“…[17] Adenoidectomy is thought to remove the reservoir of pathogens that transiently colonize in the upper respiratory tract mucosa and contribute to the development of OM. [18] Recently, it has been suggested that chronic OM is associated with the persistence of bacterial pathogens in biofilms despite the use of antibiotics. This finding has been supported by animal studies.…”

Профілактика Частих Повторних Захворювань Носоглотки В Дітей Із Гіперплазією Лімфоглоткового Кільця

“…Колонізація па-тогенними бактеріями була виявлена в 57,5 % дітей із хронічним аденоїдитом одночасно із вторинним ураженням миготливого епітелію, що сприяє під-тримці хронічної запальної реакції [1]. Патогенні бактерії присутні на слизовій оболонці аденоїдів ді-тей із хронічним середнім отитом, сприяючи трива-лій персистенції збудників та стійкості до лікування антибіотиками [11]. У таких випадках видалення аденоїдів нерідко є неефективним і потребує по-вторних втручань [3].…”

Prevention of Pneumococcal Infection in Children with Chronic Diseases of the Nasopharynx Reduces the Incidence of Other Respiratory Tract Infections: Results of a Comparative Prospective Study

“…Наиболее типичные представители бактериальных ассоциаций биопленок -Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa [13,14]. В исследованиях показано, что ассоциация этих бактерий играет одну из ключевых ролей в персистенции воспа-ления в носоглотке [15,16].…”