title: The presence of biofilm-producing bacteria on tonsils is associated with increased exhaled nitric oxide levels: preliminary data in children who experience recurrent exacerbations of chronic tonsillitis.
abstract: BACKGROUND
  It has been suggested that bacterial biofilms may be a causative factor in the aetiopathogenesis of chronic tonsillitis. Involvement of exhaled nitric oxide has been previously considered, with conflicting findings.
  
  
  OBJECTIVE
  A pilot study was performed to investigate the relationship between exhaled nitric oxide levels and the presence of tonsillar biofilm-producing bacteria in children with chronic tonsillitis.
  
  
  METHODS
  Tonsillar biofilm-producing bacteria on bioptic specimens taken during tonsillectomy were assessed by means of spectrophotometry.
  
  
  RESULTS
  Analysis was based on 24 children aged 5-10 years (median, 7.5 years). Biofilm-producing bacteria were found in 40.9 per cent of specimens. The median exhaled nitric oxide level was 11.6 ppb (range, 3.2-22.3 ppb). There was a significant relationship between the presence of biofilm-producing bacteria and increased exhaled nitric oxide levels (p = 0.03). Children with exhaled nitric oxide levels of more than 8 ppb were at three times greater risk of developing tonsillar biofilm-producing bacteria than those with lower levels.
  
  
  CONCLUSIONS
  Our findings suggest the possibility of discriminating children with chronic biofilm-sustained tonsillar infections on the basis of exhaled nitric oxide levels.
authors: Department of Clinical Sciences and Community Health,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Università degli Studi di Milano,Italy.
authors: S
authors: S
authors: Torretta
authors: Department of Physiopathology and Transplantations,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Università degli Studi di Milano,Italy.
authors: P
authors: P
authors: Marchisio
authors: Clinical Chemistry and Microbiology Laboratory, IRCCS Galeazzi Hospital and Laboratory of Microbiology and Technological Sciences for Laboratory Medicine,Department of Biomedical Sciences for Health,Università degli Studi di Milano,Italy.
authors: L
authors: L
authors: Drago
authors: Department of Surgical and Dental Biomedical Sciences,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Università degli Studi di Milano,Italy.
authors: P
authors: P
authors: Capaccio
authors: Department of Physiopathology and Transplantations,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Università degli Studi di Milano,Italy.
authors: E
authors: E
authors: Baggi
authors: Department of Clinical Sciences and Community Health,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Università degli Studi di Milano,Italy.
authors: L
authors: L
authors: Pignataro
mesh_terms: D018441:Biofilms / Q000254:growth & development*; D001944:Breath Tests / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D045853:Exhalation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D019001:Nitric Oxide Synthase / Q000378:metabolism; D014066:Palatine Tonsil / Q000382:microbiology*; D010865:Pilot Projects; D011552:Pseudomonas Infections / Q000378:metabolism / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification / Q000502:physiology; D012008:Recurrence; D013053:Spectrophotometry / Q000379:methods; D013203:Staphylococcal Infections / Q000378:metabolism / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000502:physiology; D013290:Streptococcal Infections / Q000378:metabolism / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000302:isolation & purification / Q000502:physiology; D014068:Tonsillectomy / Q000379:methods; D014069:Tonsillitis / Q000378:metabolism / Q000382:microbiology* / Q000601:surgery
chemical_list: D009569:Nitric Oxide; D019001:Nitric Oxide Synthase
keywords: Children