Bacteriologic comparison of tonsil core in recurrent tonsillitis and tonsillar hypertrophy.
OBJECTIVE
Although many bacteriology studies on tonsillar diseases have been completed, all have been confined to children and were characterized by a paucity of cases. The purpose of this study was to analyze the underlying bacterial pathogens in tonsillar disease.


METHODS
A retrospective study was performed on 824 patients who underwent elective tonsillectomy with or without adenoidectomy. We analyzed the differences between the bacterial pathogens in recurrent tonsillitis and tonsillar hypertrophy with regard to age, season, and antibiotic sensitivity.


RESULTS
Among 824 cases, 966 bacterial strains from the tonsil core were isolated. In recurrent tonsillitis, Staphylococcus aureus was the most common pathogen (30.3%), followed by Haemophilus influenzae (15.5%) and group A beta-hemolytic Streptococcus (Streptococcus pyogenes, 14.4%). In patients over 14 years of age, quite differently from other age groups, Klebsiella pneumoniae was isolated at a significantly higher percentage. In tonsillar hypertrophy, H. influenzae was isolated most commonly (31.4%) regardless of age, followed by S. pyogenes (24.2%), S. aureus (22.9%), and Streptococcus pneumoniae (12.6%). Furthermore, mixed infection was common because of its high resistance to penicillin. In both groups, S. pneumoniae was more common in younger patients, whereas K. pneumoniae was relatively common in adults. We found no differences in the detection rate by season; however, H. influenzae was frequently isolated in the tonsillar hypertrophy group regardless of seasonal variations. We also found no difference in the antibiotic sensitivity between the two groups; however, strains resistant to penicillin were relatively prevalent and showed a high sensitivity to third-generation cephalosporin.


CONCLUSIONS
We observed some differences in the types of bacteria in the tonsillar core between the recurrent tonsillitis and tonsillar hypertrophy groups. Our study indicates that essential bacteria have been changing and, thus, we need to change our choice of antibiotics.
Jeong
Jin Hyeok
JH
Department of Otolaryngology, College of Medicine, Hanyang University, Seoul, Korea.
Lee
Dong Wook
DW
Ryu
Ri A
RA
Lee
Young Sup
YS
Lee
Seung Hwan
SH
Kang
Jung Oak
JO
Tae
Kyung
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000382:microbiology*; D001431:Bacteriological Techniques / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D014066:Palatine Tonsil / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D014068:Tonsillectomy; D014069:Tonsillitis / Q000382:microbiology* / Q000601:surgery