title: Microarray identification of bacterial species in peritonsillar abscesses.
abstract: Peritonsillar abscess (PTA) is the most common otorhinolaryngological infection, requiring management at the special healthcare level. The microbiological findings vary due to geographical, etiological, and methodological factors. This study aimed to identify the bacterial species of PTAs by using a novel polymerase chain reaction (PCR)- and microarray-based assay, and to find causative cofactors among patients with different pathogens. We determined the bacterial findings of aspirates of pus prospectively collected from 180 PTA patients. Samples were pretreated prior to nucleic acid extraction and analyzed with a PCR- and microarray-based assay or DNA sequencing. Both methods were based on the gyrB/parE topoisomerase genes. Patients answered symptom questionnaires at admission, and their medical records were reviewed later. Altogether, 160 (89 %) aspirates of pus tested positive for bacteria, and a bacterial species was identified in 149 (83 %) of the samples. A polybacterial species was detected in 20 (13 %) and anaerobic bacteria in 77 (52 %) of the 149 samples. Fusobacterium necrophorum patients were younger (p < 0 .001) and had more severe symptoms (p = 0.04) than patients with other pathogens. Gender, smoking, or preadmission antibiotics showed no correlation with any of the pathogens. Although requiring some optimization, this microarray assay seems feasible and fast for bacterial identification directly from pus samples, and confirms the diversity of PTA pathogens. Young patients with more severe symptoms may require special attention. Species-specific antibiotic treatment of PTA remains challenging due to bacterial variations; the present assay may aid in specifying PTA antibiotic treatment in the future.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland, johanna.wiksten@hus.fi.
authors.forename: J E
authors.initials: JE
authors.lastname: Wikstén
authors.forename: S
authors.initials: S
authors.lastname: Laakso
authors.forename: M
authors.initials: M
authors.lastname: Mäki
authors.forename: A A
authors.initials: AA
authors.lastname: Mäkitie
authors.forename: A
authors.initials: A
authors.lastname: Pitkäranta
authors.forename: K
authors.initials: K
authors.lastname: Blomgren
mesh_terms: D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000382:microbiology* / Q000473:pathology; D060085:Coinfection / Q000382:microbiology / Q000473:pathology; D027081:DNA Gyrase / Q000235:genetics; D027101:DNA Topoisomerase IV / Q000235:genetics; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D046228:Microarray Analysis / Q000379:methods*; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D000039:Peritonsillar Abscess / Q000382:microbiology* / Q000473:pathology; D016133:Polymerase Chain Reaction / Q000379:methods; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D017422:Sequence Analysis, DNA; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D027101:DNA Topoisomerase IV; D027081:DNA Gyrase