Quantitative Bacterial Culture from Adenoid Lymphatic Tissue with Special Reference toHaemophilus influenzaeAge-associated Changes

Abstract

Homogenized adenoid tissue from 55 children (28-153 months) undergoing adenoidectomy because of nasopharyngeal obstruction was investigated by means of quantitative aerobic bacterial culture. The children were divided into two groups, the hypertrophy alone group--AH (n = 29)--and the hypertrophy with longstanding secretory otitis media group--SOM (n = 26). A nasopharyngeal culture was obtained preoperatively from 38 of the cases. Non-typeable H. influenzae (NTHI) was found in twice as many cases in the AH group as in the SOM group, 21/29 (72%) compared to 11/26 (42%) (p < 0.05) and in a significantly higher mean concentrations, 5.7 x 10(5) CFU/g compared to 1.9 x 10(5) CFU/g (p = 0.02). For the other aerobic potentially pathogenic bacteria no such difference was found. The bulk of the NTHI-positive cases and the cases with the highest concentrations were found in the children below the age of 6 years. In the nasopharyngeal cultures NTHI alone or together with S. pneumoniae and/or B. catarrhalis was found in 29% of the cases in both the AH group and SOM group. NTHI was found in only 50% of the nasopharyngeal cultures corresponding to a positive quantitative culture (10/20). These findings suggest that NTHI is harboured within the adenoid and could thereby chronically stimulate the local immune defense. However, the present study indicates that there is no aerobic bacterial overload in the adenoid tissue in children with SOM compared to children without middle-ear disease.

Cytokines in nasopharyngeal secretions; evidence for defective IL-1β production in children with recurrent episodes of acute otitis media

“…In a recent study of bacterial load on homogenized adenoid lymphatic tissue, H. infiuenzae was found in only 50% of the nasopharyngeal cultures corresponding to a positive quantitative culture. This suggests that bacteria are harboured in crypts or in the lymphatic tissue [22]. In a recent study it has been possible to demonstrate H. infiuenzae intracellularly in macrophages by electron microscopy and by RNA hybridization [23].…”

Relationship between bacteriology of the adenoid core and middle meatus in children with sinusitis

“…9 Most published studies of adenoid bacteriology have investigated the bacteriology of the adenoid surface rather than its core. 10,11 The present study sought to address this issue, and to assess the correlation between the bacteriology of paediatric sinusitis and the prevalence of bacterial pathogens in the adenoid core.…”

Differential expression of Immunoglobulin A in the adenoids of children with and without exudative otitis media

“…Quantitative bacterial studies have shown that nontypeable H. influenzae is isolated from homogenized adenoid tissues more often than from nasopharyngeal cultures in the same individual, suggesting that this organism is harbored within the adenoids [18]. SIgA can inhibit initial pathogen colonization through immune exclusion, both on the mucosal surface and within virusinfected secretory epithelial cells, and it can block microbial toxins and other antigens.…”