Association between Tonsillar Core Microflora and Post-tonsillectomy Bacteremia

Abstract

The aim of the study was to determine whether the population levels of aerobic and anaerobic bacteria in the core tonsils of adults with recurrent acute tonsillitis in uence the developmen t of post-tonsillectomy bacteremia. F or that purpose we performed qualitative and quantitative bacteriology of 24 excised tonsillar core specimens, together with aerobic and anaerobic perioperative blood cultures. The blood cultures from ten non-surgica l patients with recurrent acute tonsillitis served as controls to determine the occurrence of baseline bacteremia . Post-tonsillectomy bacteremia was foun d in nine (38%) patients. Isolated bacteria were a-hemolytic streptococci (n ¾ 2), group C b-hemolytic streptococci (n ¾ 2), group A b-hemolytic streptococcus (GAS) (n ¾ 1), Peptostreptococcus sp. (n¾ 1), Bacteroides sp. (n ¾1) and Prevotella sp. (n ¾ 2). N one of the blood cultures from the controls were positive. M ixed aerobic and anaerobic bacterial ora was foun d in the tonsil cores from both the patients with blood culture positive or negative results. All blood culture isolates were also recovered in the correspondin g tonsillar core, excep t for the GAS. However , its presence was subsequently demonstrated by PCR . In further analysis, we found no correlation between the bacterial population levels and the developmen t of post-tonsillectomy bacteremia . The absence of G AS growth from the core tonsil of a patient with G AS bacteremia also suggest s that translocation of certain bacteria may occu r in spite of low counts. In conclusion , the occurrence of post-tonsillectomy bacteremia is quite frequent in adults and the spectrum of invading agent s is variable.

Selection of indicators for tonsillectomy in adults with recurrent tonsillitis

“…The bacteriological culture was performed according to the previously described method [18]. Briefly, after excision, one of the tonsils was placed in a sterile Petri dish and taken immediately to the microbiology laboratory.…”

Macroscopic oropharyngeal signs indicating impaired defensive function of palatine tonsils in adults suffering from recurrent tonsillitis

“…Several studies have found an abundance of potentially pathogenic bacteria in recurrently inflamed palatine tonsils (8–11); however, many others have described normal flora (12–14). In our previous study, no correlation was found between the bacterial population levels in the tonsillar microflora and the development of post‐tonsillectomy bacteremia (5).…”

“…The occurrence of post-tonsillectomy bacteremia is a well-recognised phenomenon, with reported incidences of 20-40% in children and adults (2)(3)(4)(5). The process where viable bacteria penetrate mucosal surfaces to reach the bloodstream and other normally sterile body sites has been defined as bacterial translocation (6).…”

Conformance of Mc Isaac Modification of Centor Score with Microorganisms of Tonsil Core Tissue in Chronic Tonsillitis Patients

“…10 Many distinct kinds of microorganisms were detected in the tonsil core as opposed to the tonsil surface in the culture results recovered from the tonsillar surface swabs and tonsillar core tissue, particularly anaerobic bacteria. 14,15,16 The Mc Isaac Modified Centor criteria were the most recent parameters utilized to determine the etiology of tonsillitis. This score is primarily used to identify tonsillitis produced by the GABHS virus and to assist distinguish between tonsillitis caused by bacteria or viruses.…”