Comparison of the microbiology of recurrent tonsillitis between children and adults

The microbial flora of recurrently inflamed tonsils removed from 25 children with recurrent episodes of tonsillar pharyngitis were compared to flora of tonsils removed from 23 adults suffering from similar illness. More bacterial isolates per tonsil were recovered in adults (10.2 per tonsil) than in children (8.4 per tonsil). The difference between these groups was due to a higher recovery rate in adults of Bacteroides melaninogenicus group (1.6 isolates per adult, 0.8 per child) and Bacteroides fragilis group (0.4 per adult, 0.2 per child). Conversely, Group A beta-hemolytic streptococci were isolated in seven (28%) children as compared to their isolation in one (4%) adult. More isolates of beta-lactamase-producing organisms (BLPO) per tonsil were recovered in adults. Forty-three BLPO were detected in 21 (91%) of the 23 tonsils removed from adults (1.9 isolates per patient) as compared to 31 isolates in 16 (64%) of the 25 tonsils removed from children (1.2 isolates per patient) (P = 0.04). These findings suggest that the etiology of recurrent tonsillitis in adults may differ from that in children. The differences in the tonsillar flora may be due to the effect of many more courses of antimicrobials given over the years to adults and the changes in tonsillar tissue that occur in this age group.