title: [Environmental scanning electron microscopy for biofilm detection in tonsils].
abstract: OBJECTIVE
  To describe an environmental scanning electron microscopic method for the study of biofilms in clinical samples. A comparison with standard scanning electron microscopy is performed.
  
  
  METHODS
  Nine patients with a past history of recurrent tonsillitis underwent tonsillectomy. Samples from each patient were obtained for both conventional and environmental scanning electron microscopy. The tonsils removed from 2 patients with sleep apnoea syndrome were used as controls.
  
  
  RESULTS
  Eight of nine tonsils had biofilms on their surface. Scanning electron microscopy showed accumulations of bacteria covered by fibrillar structures resulting from the sample dehydration process. Environmental scanning electron microscopy provided a view of bacteria embedded in a homogeneous, amorphous substance that was preserved during the examination.
  
  
  CONCLUSIONS
  Environmental scanning electron microscopy permits the imaging of wet systems at different degrees of dehydration. It therefore allows researchers to observe biofilms in their natural hydrated state.
authors.affiliation: Grupo de Investigación Otológica, Servicio de Otorrinolaringología, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Ramírez-Camacho
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: González-Tallón
authors.forename: David
authors.initials: D
authors.lastname: Gómez
authors.forename: Almudena
authors.initials: A
authors.lastname: Trinidad
authors.forename: Andrés
authors.initials: A
authors.lastname: Ibáñez
authors.forename: José Ramón
authors.initials: JR
authors.lastname: García-Berrocal
authors.forename: José María
authors.initials: JM
authors.lastname: Verdaguer
authors.forename: José Angel
authors.initials: JA
authors.lastname: González-García
authors.forename: Julio
authors.initials: J
authors.lastname: San Román
mesh_terms: D000328:Adult; D001419:Bacteria / Q000302:isolation & purification* / Q000648:ultrastructure*; D018441:Biofilms; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D014068:Tonsillectomy; D014069:Tonsillitis / Q000382:microbiology* / Q000601:surgery*