title: Resistant bacteria in the adenoids: a preliminary report.
abstract: OBJECTIVE
  To determine the incidence of resistant bacteria in adenoid cultures from children with and without middle ear disease and rhinosinusitis symptoms.
  
  
  METHODS
  Children meeting the requirement for tympanostomy tube placement underwent an adjuvant adenoidectomy for symptoms of adenoid hypertrophy or recurrent rhinosinusitis. Adenoid tissue and coexisting middle ear fluid, if present, were cultured.
  
  
  METHODS
  Tertiary referral children's hospital with community-based satellite clinics.
  
  
  METHODS
  Forty-six patients ranging in age from 1 to 11 years (68% <3 years) with recurrent or persistent otitis media and symptoms of adenoid hypertrophy or rhinosinusitis (study patients) underwent tympanostomy tube placement and adenoidectomy with culture of the adenoids and middle ear effusions. Eighteen patients with adenoid hypertrophy without ear disease or rhinosinusitis were used as controls.
  
  
  METHODS
  Tympanostomy tube placement and adenoidectomy.
  
  
  METHODS
  Presence or absence of resistant bacteria.
  
  
  RESULTS
  Resistant bacteria were found in cultures of the adenoids in 56% (26/46) of the study group compared with 22% (4/18) of the control patients (P<.02). Also, strains of Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis were found in cultures from 78% (36/ 46) of the study group, compared with 44% (8/18) of those from the control group (P<.01). Resistant isolates were found in 65% (23/35) of the S. pneumoniae, 37% (18/49) of the H. influenzae, and 100% (19/19) of the M. catarrhalis cultures from the adenoids or middle ear spaces.
  
  
  CONCLUSIONS
  Resistant bacteria are present in significant amounts in the adenoids of children with middle ear disease and rhinosinusitis symptoms compared with patients without those diseases or symptoms.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, University of Texas Southwestern Medical Center at Dallas, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: McClay
mesh_terms: D000234:Adenoids / Q000382:microbiology*; D000293:Adolescent; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D018432:Drug Resistance, Multiple; D004432:Ear, Middle / Q000382:microbiology; D005260:Female; D006193:Haemophilus influenzae / Q000187:drug effects; D006801:Humans; D008297:Male; D001936:Moraxella catarrhalis / Q000187:drug effects; D010033:Otitis Media / Q000188:drug therapy / Q000382:microbiology; D012016:Reference Values; D013296:Streptococcus pneumoniae / Q000187:drug effects