Bacteriology and Antibiotic Susceptibility Pattern of Peitonsillar Abscess

Abstract

INTRODUCTION:
 Peritonsillar abscess is a common complication of acute tonsillitis. Its management consists of aspiration or surgical drainage followed by appropriate antibiotics. Appropriate antibiotic treatment depends on the common organisms associated with infection and their antibioticsensitivity pattern in local scenario.
 METHODS:
 Pus samples aspirated from diagnosed cases of peritonsillar abscess and submitted for culture and sensitivity in last two years were included in this study. Identification of different microorganisms was made on the basis of the microscopic findings, observation of their colony morphology and standard biochemical reactions. Susceptibility pattern to commonly used antibiotics were determined by Clinical Laboratory Standards Institute (CLSI) guidelines.
 RESULTS:
 Altogether 24 pus samples were included in the study. Positive culture was obtained from 18 samples. Among them one organism was isolated from 13 samples whereas from five samples multiple organisms were isolated. From six samples no organisms could be cultured. Altogether Streptococcus pyogenes was isolated from 12 samples and Staphylococcus aureus from five samples. Other isolated organisms included Haemophlilus influenzae, Pseudomonas aeruginosa, Escherichia coli and Enterococcus species. Penicillin was effective for Streptococcus pyogenes whereas Staphylococcus aureus was resistant to it. Cloxacillin was found to be effective for Staphylococcus aureus. Ciprofloxacin and Ceftazidime were found to be effective for both organisms.
 CONCLUSIONS:
 Streptococcus pyogenes and Staphylococcus aureus were more commonly associated with peritonsillar abscess. Streptococcus pyogenes were sensitive to penicillin but all Staphylococcus aureus were resistant to it. This fact should be considered in clinical practice for management of peritonsillar abscess.
 KEYWORDS: Bacteriology, Peritonsillar abscess, Susceptibility pattern.

Peritonsillar abscess: Treatment with immediate tonsillectomy – 10 years of experience

“…Patients usually present with severe throat pain, fever, drooling, foul breath, trismus, neck swelling, and altered voice resonance. Microbiological findings for peritonsillar abscesses include both aerobic and anaerobic components [3,[5][6][7][8]. The aerobic bacterium Streptococcus pyogenes is isolated in nearly a third of cases [1].…”

Microbial Flora and Antibiotic Resistance in Peritonsillar Abscesses in Upstate New York

“…4,5 There is debate as to how common penicillin resistance is in peritonsillar abscesses, ranging from 0% to 68%. A 37.5% penicillin resistance rate in Staphylococcus is similar to what is reported in the literature, with a range of 0% to 52%.…”

“…4,5 There is debate as to how common penicillin resistance is in peritonsillar abscesses, ranging from 0% to 68%. [2][3][4] The presence of clindamycin and erythromycin resistance in Streptococcus and Staphylococcus seen in this study is also demonstrated by prior studies. 2 The majority of penicillin resistance reported appears to be due to β-lactamase production.…”

“…2,4,7,13,14 It is important to note that penicillin resistance is more common in peritonsillar abscesses with deep neck space involvement, and there were patients with parapharyngeal or retropharyngeal space involvement included in this study. 4,13 In terms of antibiotic resistance and patient age, there does not appear to be a trend based on patient age. [2][3][4] The presence of clindamycin and erythromycin resistance in Streptococcus and Staphylococcus seen in this study is also demonstrated by prior studies.…”

A Study to Find Out the Bacteriology of Tonsillar Surface and Core, Among Patients Undergoing Tonsillectomy at a Tertiary Care Hospital in South India

“…Other studies have also found similar results with Staphylococcal specimens showing high levels of anti-microbial resistance, and Streptococcal species being relatively susceptible to first line antibiotics. (10) Another interesting aspect of drug susceptibility testing was that 80% of the Pseudomonas samples were resistant to third generation cephalosporins, indicating a possible presence of Extended Spectrum Beta Lactamase (ESBL). Phenotyping and Polymerase Chain Reaction (PCR) would have been the obvious choice of looking for ESBL, but it was not done as institutional facilities were not available.…”