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Resistant bacteria in the adenoids: a preliminary report
1Department of Otolaryngology--Head and Neck Surgery, University of Texas Southwestern Medical Center at Dallas, USA.
Insights
Resistant bacteria are frequently found in the adenoids of children with ear and sinus issues. This study highlights a higher incidence in children with middle ear disease and rhinosinusitis compared to controls.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Middle ear disease and rhinosinusitis are common in children.
- Adenoids are a potential reservoir for bacteria implicated in these conditions.
- Antibiotic resistance is a growing global health concern.
Purpose of the Study:
- To investigate the prevalence of antibiotic-resistant bacteria in adenoid tissue.
- To compare bacterial resistance in children with and without middle ear disease and rhinosinusitis.
- To identify common resistant bacterial strains in pediatric adenoid cultures.
Main Methods:
- Adenoidectomy and middle ear fluid cultures were performed on 46 children with ear/sinus symptoms undergoing tympanostomy tube placement.
- Eighteen children with adenoid hypertrophy but no ear/sinus disease served as controls.
- Cultures were analyzed for the presence and type of resistant bacteria.
Main Results:
- Resistant bacteria were identified in 56% of study patients versus 22% of controls (P<.02).
- Common respiratory pathogens like Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were found in 78% of study patients.
- High resistance rates were observed for S. pneumoniae (65%), H. influenzae (37%), and M. catarrhalis (100%).
Conclusions:
- Children with middle ear disease and rhinosinusitis exhibit a significantly higher incidence of resistant bacteria in their adenoids.
- Adenoids serve as a reservoir for antibiotic-resistant pathogens in pediatric otolaryngology and infectious disease.
- Findings underscore the importance of considering bacterial resistance in treating recurrent pediatric ear and sinus infections.
Objective:
To determine the incidence of resistant bacteria in adenoid cultures from children with and without middle ear disease and rhinosinusitis symptoms.
Design:
Children meeting the requirement for tympanostomy tube placement underwent an adjuvant adenoidectomy for symptoms of adenoid hypertrophy or recurrent rhinosinusitis. Adenoid tissue and coexisting middle ear fluid, if present, were cultured.
Setting:
Tertiary referral children's hospital with community-based satellite clinics.
Patients:
Forty-six patients ranging in age from 1 to 11 years (68% <3 years) with recurrent or persistent otitis media and symptoms of adenoid hypertrophy or rhinosinusitis (study patients) underwent tympanostomy tube placement and adenoidectomy with culture of the adenoids and middle ear effusions. Eighteen patients with adenoid hypertrophy without ear disease or rhinosinusitis were used as controls.
Interventions:
Tympanostomy tube placement and adenoidectomy.
Main Outcome Measures:
Presence or absence of resistant bacteria.
Results:
Resistant bacteria were found in cultures of the adenoids in 56% (26/46) of the study group compared with 22% (4/18) of the control patients (P<.02). Also, strains of Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis were found in cultures from 78% (36/ 46) of the study group, compared with 44% (8/18) of those from the control group (P<.01). Resistant isolates were found in 65% (23/35) of the S. pneumoniae, 37% (18/49) of the H. influenzae, and 100% (19/19) of the M. catarrhalis cultures from the adenoids or middle ear spaces.
Conclusion:
Resistant bacteria are present in significant amounts in the adenoids of children with middle ear disease and rhinosinusitis symptoms compared with patients without those diseases or symptoms.