Anatomical Evidence of Microbial Biofilms in Tonsillar Tissues

Abstract

There is strong anatomical evidence for the presence of bacterial biofilms in chronically diseased tonsils. Because sessile bacteria within biofilms are resistant to host defenses and antibiotics, bacterial biofilms within tonsils may explain the chronicity and recurrent nature of some forms of tonsillitis.

Multimodal optical mesoscopy reveals the quantity and spatial distribution of Gram‐positive biofilms in ex vivo tonsils

“…Our results show that biofilms were present in all ( n = 36) specimens imaged. This result is to the contrary of other studies including the work of Chole and Faddis, 3 which have reported smaller positive outcomes. We attribute our findings to the greatly increased imaging volume with high spatial resolution that is possible with the Mesolens compared to other imaging methods.…”

Evidence of Bacterial Biofilms among Infected and Hypertrophied Tonsils in Correlation with the Microbiology, Histopathology, and Clinical Symptoms of Tonsillar Diseases

“…In our study, bacterial biofilms were present in 60% of tonsils. This was similar to previous findings were biofilms were present in 61% and 70% of examined tonsils, respectively [ 6 , 18 ]. The high prevalence of biofilm among our tonsils suggests that chronic and recurrent tonsillitis and obstructive sleep apnea are caused by biofilm-forming pathogens.…”

The presence of biofilm-producing bacteria on tonsils is associated with increased exhaled nitric oxide levels: preliminary data in children who experience recurrent exacerbations of chronic tonsillitis

“…In our study, the presence of tonsillar biofilm-producing bacteria was detected (by spectrophotometric evaluation) in about 50 per cent of tonsillar samples, which is in line with previous reports that suggest the possible involvement of bacterial biofilm in paediatric chronic tonsillar disease 1 , 2 , 6 , 13 . Although bacterial biofilm is generally evaluated by means of advanced electron microscopic analysis, such as scanning electron microscopy or confocal laser scanning microscopy, these techniques require costly equipment and extensive sample preparation.…”

“…In our case series, S aureus was the most frequently detected biofilm-producing bacteria (78.6 per cent) followed at a considerable distance by S pyogenes (14.3 per cent). This finding confirms the results of previous studies that indicate the predominant involvement of Gram-positive organisms in biofilm-related chronic tonsillar infections 1 , 2 , 6 , 13 …”