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Microbial Composition, Antibiotic Sensitivity Patterns, and Contributing Factors Among Children With Tonsillitis in
Tebiku Daniel Tirago1, Mesfin Worku1, Tadesse Menjetta Nima1
1School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Insights
Bacterial tonsillitis is common in Ethiopian children, with Streptococcus pyogenes being the most frequent cause. Antibiotic resistance is a significant concern, highlighting the need for targeted treatment strategies.
Area of Science:
- Medical Microbiology
- Pediatric Infectious Diseases
- Public Health
Background:
- Tonsillitis is frequent in children aged 5-14 due to developing immunity and poor antibiotic penetration.
- This study addresses the need to understand bacterial profiles and antibiotic susceptibility in pediatric tonsillitis.
Purpose of the Study:
- To determine the bacterial profile of tonsillitis in children.
- To assess the antibacterial susceptibility patterns of isolated bacteria.
- To identify factors associated with bacterial tonsillitis in Ethiopian children.
Main Methods:
- An institution-based cross-sectional study was conducted in Hawassa town, Ethiopia.
- Data collected via interviewer-administered questionnaires and throat swab cultures.
- Antimicrobial susceptibility testing used the disc diffusion method; logistic regression analyzed associated factors.
Main Results:
- The prevalence of bacterial tonsillitis was 67.6% among 408 children.
- Dominant isolates included Streptococcus pyogenes (25.4%), Staphylococcus aureus (21.4%), and Staphylococcus epidermidis (20.3%).
- High resistance observed for S. pyogenes against cephalexin, penicillin, and ceftriaxone; low income, enlarged glands, and recurrent tonsillitis were associated factors.
Conclusions:
- Bacterial tonsillitis is highly prevalent in the study area.
- Significant antibiotic resistance, including to penicillin and ceftriaxone, was noted.
- Culture and susceptibility testing are crucial for effective management of pediatric bacterial tonsillitis.
Abstract:
Background: Infections of the tonsils are very frequent among 5-14-year-old children due to poor immunity establishments and inflammation within the tonsils because of insufficient penetration of antibiotics into the tonsillar core. This study was aimed at determining the bacterial profile, antibacterial susceptibility pattern, and associated factors among children with tonsillitis from selected health facilities in Hawassa town, Sidama, Ethiopia. Methods: An institution-based cross-sectional study was conducted using interviewer-administered, pretested questionnaires, and throat swab samples were collected from children with tonsillitis visiting selected health facilities in Hawassa town. A systematic random sampling technique was used to select the study units. Antimicrobial susceptibility testing was carried out by using the disc diffusion method according to criteria set by the Clinical Laboratory and Standard Institute 2020. Logistic regression evaluated factors related to the prevalence of culture-confirmed bacterial tonsillitis. Results: The overall prevalence of bacterial tonsillitis among children (408) with tonsillitis among selected health facilities was 276/408 (67.6%) (95% CI: 63.0%, 72.0%). The dominant bacterial isolate was Streptococcus pyogenes (70) (25.4%), followed by Streptococcus aureus (59) (21.4%), Staphylococcus epidermidis (56) (20.3%), Streptococcus pneumoniae (35) (12.7%), and Haemophilus influenzae (27) (9.8%). S. pyogenes was resistant to cephalexin (45.7%), penicillin (44.3%), and ceftriaxone (42.9%). Higher odds of having bacterial tonsillitis were observed for children from low monthly income families (adjusted odds ratio (AOR) 2.31, 95% CI: 1.15-4.63), those with enlarged or tender glands (AOR 2.47, 95% CI: 1.57-3.88), and those with a history of recurrent tonsillitis (AOR 1.85, 95% CI: 1.18, 2.92). Conclusions: Bacterial tonsillitis was prevalent in the study area. The isolates showed resistance to common antibiotics such as penicillin, chloramphenicol, clindamycin, ceftriaxone, and cephalexin. Therefore, culture and susceptibility tests are vital for appropriately managing bacterial tonsillitis.
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