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Aerobic and anaerobic bacteria in tonsils of children with recurrent tonsillitis
Insights
Recurrent tonsillitis in children involves a mix of aerobic and anaerobic bacteria deep within the tonsils. Many of these bacteria produce beta-lactamase, an enzyme that can resist common antibiotics.
Area of Science:
- Microbiology
- Pediatric Infectious Diseases
- Otolaryngology
Background:
- Recurrent tonsillitis is a common pediatric condition.
- The microbial flora within tonsils, especially in recurrent cases, is not fully understood.
- Antibiotic resistance is a growing concern in treating bacterial infections.
Purpose of the Study:
- To characterize the aerobic and anaerobic microbial flora in the deep tonsillar tissue of children with recurrent tonsillitis.
- To identify the prevalence of beta-lactamase-producing microorganisms within this flora.
- To understand the implications for antibiotic treatment strategies.
Main Methods:
- Tonsils were collected from 50 children diagnosed with recurrent tonsillitis.
- Core tonsillar material was cultured for both aerobic and anaerobic microorganisms.
- Beta-lactamase production was tested for isolated bacterial species.
Main Results:
- A polymicrobial flora, averaging 7.8 isolates per specimen (4.1 anaerobic, 3.7 aerobic), was consistently found.
- Predominant anaerobic isolates included Bacteroides sp. and Fusobacterium sp.
- Predominant aerobic isolates included alpha-hemolytic streptococci and Staphylococcus aureus.
- Beta-lactamase production was detected in 56 isolates from 37 patients (74%), notably in Staphylococcus aureus, Bacteroides fragilis, Bacteroides melaninogenicus, and Haemophilus influenzae type B.
Conclusions:
- The deep tonsillar flora in children with recurrent tonsillitis is complex and polymicrobial, involving both aerobic and anaerobic bacteria.
- A significant proportion of these deep tonsillar microorganisms produce beta-lactamase, potentially impacting treatment efficacy.
- These findings highlight the need to consider the presence of beta-lactamase-producing bacteria when selecting antibiotics for recurrent tonsillitis.
Abstract:
Tonsils were obtained from 50 children suffering from recurrent tonsillitis. Patients' ages ranged from 2.5 to 17 years (mean 6 years); 29 were males and 21 females. The tonsils were sectioned in half after heat searing of the surface and the core material was cultured for aerobic and anaerobic microorganisms. Mixed aerobic and anaerobic flora was obtained in all patients, yielding an average of 7.8 isolates (4.1 anaerobes and 3.7 aerobes) per specimen. There were 207 anaerobes isolated. The predominant isolates were 101 Bacteroides sp (including 10 B fragilis group, and 47 B melaninogenicus group), 29 Fusobacterium sp, 34 Gram-positive anaerobic cocci (25 Peptococcus sp and 9 Peptostreptococcus sp) and 16 Veillonella sp. There were 185 aerobic isolates. The predominant isolates were 41 alpha-hemolytic streptococci, 24 Staphylococcus aureus, 19 beta-hemolytic streptococci (11 group A, 4 group B, and 2 each group C and F), 14 Haemophilus sp (including 12 H influenzae type B) and 5 H parainfluenzae. Beta-lactamase production was noted in 56 isolates recovered from 37 tonsils. These were all isolates of S aureus (24) and B fragilis (10), 15 of 47 B melaninogenicus (32%), 5 of the 12 B oralis (42%), and 2 of 12 H influenzae type B (17%). Our findings indicate the polymicrobial aerobic and anaerobic nature of deep tonsillar flora in children with recurrent tonsillitis, and demonstrate the presence of many beta-lactamase-producing organisms in 74% of the patients.