Bacteriology of symptomatic adenoids in children

Abstract

Background:Children with adenoid hypertrophy have been shown to harbor pathogenic bacteria in the nasopharynx despite antibiotics. Removal of the adenoid is associated with a reduction in the bacterial count.Aims:The study was done to determine the bacteriology of the adenoid tissue in chronic adenotonsillitis and adenoid hypertrophy, and determine the antibiotic sensitivity of potential pathogens.Materials and Methods:This is a descriptive study conducted on 100 patients aged between three and twelve years who underwent adenotonsillectomy/adenoidectomy. After adenoidectomy, the specimen along with the swab taken from the surface of the adenoid was sent for microbiological examination. After 48 and 96 hours, the microbial growth was identified and the antibiotic-sensitivity pattern of the isolate was studied.Results:Aerobic organisms grew in 93% of the specimens and anaerobic organisms in 68%, whereas 7% had no growth. The surface was predominated by commensals and the pathogens were mainly found in the core. The predominant pathogens were Staphylococcus aureus, Streptococcus pneumoniae, and Enterococcus species. The organisms were resistant to penicillin but showed sensitivity to co-amoxiclav and ciprofloxacin. Co-amoxiclav and ciprofloxacin should be considered as the first line of medical treatment for adenotonsillar diseases.Conclusions:Infection is the main cause of adenoid hypertrophy. Amoxicillin with potassium clavulanate and ciprofloxacin should be considered as the drugs of choice for all adenotonsillar diseases. Early and prompt treatment of adenoid hypertrophy with appropriate antibiotics will avoid unnecessary exposure to repeated antimicrobial therapy, thereby maintaining the beneficial effects of the normal adenoid flora.

The Relationship between Colonization by Moraxella catarrhalis and Tonsillar Hypertrophy

“…Many studies have shown that the tonsils of patients with recurrent tonsillitis are colonized by a large number of bacteria, both pathogenic and nonpathogenic, showing that these agents possibly may play a role in the development of chronic tonsillar disease [ 1 , 7 , 21 , 25 ]. In patients undergoing adenoidectomy, for instance, there is a decrease in the detection of pathogenic agents in the nasopharyngeal region [ 26 ].…”

The cost-effectiveness analysis of drug therapy versus surgery for symptomatic adenoid hypertrophy by a Markov model

“…The surgery group has a better CE in the long term of treatment than the drug therapy according to the base-case analysis. We explain the result that the adenoid could obstruct the upper respiratory tract and the Eustachian tube, serve as a bacterial reservoir for infection and evoke the immune reaction [15,57,58], which could be removed with surgery once for all, while the incomplete remission of the drug therapy leads to a lower utility. Furthermore, the frequent recurrence of the symptoms requires another cycle of drug therapy increases the costs, making it less cost-effective [35,38].…”

Upper Respiratory Dysbiosis in Children

“…Robert P. Dickson (2014) указывает на взаимос-вязь между дисбиозом и пролонгированным воспалением в респираторном тракте, обозна-чив это состояние как «Dysbiosis-Inflammation Cycle» [4]. Пролонгированное воспаление на слизистой оболочке верхних дыхательных пу-тей и в миндалинах лимфоидного глоточно-го кольца способствует их гипертрофии и ги-перплазии [4,5,6]. Нозологическими форма-ми у детей, в патогенезе которых имеет место Dysbiosis-Inflammation Cycle, являются хрони-ческий ринит, аденоидные вегетации, гипер-трофия небных миндалин, хронический тон-зиллофарингит, бронхиальная астма, бронхоэк-татическая болезнь [3].…”