Kronik adenotonsillitli olgularda adenoid ve tonsil merkez kültürlerinin karşılaştırılması
Amaç: Kronik adenotonsillitli hastalarda tonsil veadenoid merkez kültürleri karflılafltırıldı ve beta laktamaz üreten bakteriler belirlendi. Hastalar ve Yöntemler: Kronik adenotonsillitli 32hastaya 21 erkek, 11 kız; ort. yafl 5 elektif adenotonsillektomi yapıldı. Tonsil ve adenoid dokusundansteril flartlarda alınmıfl merkez sürüntü kültürleri,aerobik üreme için %5 oranında koyun kanlı agar,eosin metilen mavi agar, çikolatalı agar besiyerlerineekildi. Patojen bakterilerde beta-laktamaz üretmeoranları incelendi. Bulgular: Tonsil ve adenoid merkez kültürlerinde ensık rastlanan patojen Staphylococcus aureus o l a r a kbelirlendi. Tonsil merkez kültürlerinde üreyen 27, adenoid merkez kültürlerinde üreyen 22 patojenin 20’s i n i n %75 aynı olduğu görüldü. Beta-laktamaz üreten bakterilerin oranı, tonsil merkez kültürlerinde %44, adenoid merkez kültürlerinde %41 bulundu. S. aureus’un tonsil merkez kültürlerinde %88, adenoid merkez kültürlerinde %100 oranında beta-laktamaz ürettiği görüldü.Sonuç: Kronik tonsillitte yüzey ve merkez kültürlerinden elde edilen farklı etkenler, hastalığın etyopatogenezi ve tedavisi yönünden önemli olabilir. Ayrıcakronik tonsillit ve adenoidit etkenleri birbirine benzemektedir
Anahtar Kelimeler:
Adenoid/cerrahi/mikrobiyoloji, antibiyotik, bakteri/izolasyon ve purifikasyon, bakteriyel enfeksiyon, betalaktamaz, çocuk, Staphylococcus aureus, tonsil/mikrobiyoloji, tonsillektomi, tonsillit/mikrobiyoloji/ilaç tedavisi/cerrahi.
Comparison of adenoid and tonsil core cultures in chronic adenotonsillitis
Objectives: Tonsil and adenoid core cultures were compared and beta-lactamase producing bacteria were determined in patients with chronic adenotonsillitis.Patients and Methods: Thirty-two patients 21 boys, 11 giriş; mean age 5 years with chronic ade notonsillitis underwent elective adenotonsillectomy.The core swaps of tonsil and adenoid tissues were obtained under sterile conditions and were inoculated in %5 sheep blood ağar, eosin methylene blue ağar, and chocolate ağar plates. The frequency of beta-lactamase producing isolates were assessed.Results: Staphylococcus aureus was the most common pathogen both in tonsil and adenoid core cultures.Among pathogenic bacteria isolated from tonsil n=27 and adeonid n=22 cultures, the same strains were isolated in 20 cultures 75% . The frequencies of beta-lac tamase producing bacteria were 44% and 41% in tonsil and adenoid core cultures, respectively. S. aureus was associated with beta-lactamase production in 88% and 100% in tonsil and adenoid tissues, respectively.Conclusion: Differences betvveen tonsil surface and core bacterial flora may have implications in the etiopathogenesis and treatment of chronic tonsillitis.The range of species isolated seems to be similar for both chronic tonsillitis and adenoiditis.
Keywords:
Adenoids/surgery/microbiology, antibiotics, bacteria/isolation & purification, bacterial infections, betalactamases, child, Staphylococcus aureus, tonsil/microbiology, tonsillectomy, tonsillitis/microbiology/drug therapy/surgery,
___
- Kornblut AD. A traditional approach to surgery of the tonsils and adenoids. Otolaryngol Clin North Am 1987; 20:349-63.
- Brook I. The role of beta-lactamase-producing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect Dis 1984;6:601-7.
- Kaygusuz İ, Gök Ü, Yalçın fi, Kelefl E, Kızırgil A, Demirbağ E. Bacteremia during tonsillectomy. Int J Pediatr Otorhinolaryngol 2001;58:69-73.
- Brook I, Yocum P. Comparison of the microbiology of group A and non-group A streptococcal tonsillitis. Ann Otol Rhinol Laryngol 1988;97(3 Pt 1):243-6.
- Brook I, Foote PA Jr. Microbiology of “normal” tonsils. Ann Otol Rhinol Laryngol 1990;99:980-3.
- Brook I, Shah K, Jackson W. Microbiology of healthy and diseased adenoids. Laryngoscope 2000;110:994-9.
- Brook I. The clinical microbiology of Waldeyer's ring. Otolaryngol Clin North Am 1987;20:259-72.
- Tuner K, Nord CE. Emergence of beta-lactamase p roducing anaerobic bacteria in the tonsils during penicillin treatment. Eur J Clin Microbiol 1986;5: 3 9 9 - 4 0 4 .
- Brook I, Shah K. Bacteriology of adenoids and tonsils in children with recurrent adenotonsillitis. Ann Otol Rhinol Laryngol 2001;110:844-8.
- Gaffney RJ, Freeman DJ, Walsh MA, Cafferkey MT. Differences in tonsil core bacteriology in adults and children: a prospective study of 262 patients. Respir Med 1991;85:383-8.
- Bilgehan H. Klinik mikrobiyolojik tanı. 3. baskı. İzmir: Barıfl Yayınları; 2002.
- Albert Balows. Manual of clinical micro b i o l o g y. 5th ed. Washington D.C.: American Society for Micro b i o l o g y ; 1 9 9 1 .
- Brook I, Yocum P, Friedman EM. Aerobic and anaero- bic bacteria in tonsils of children with recurrent tonsil- litis. Ann Otol Rhinol Laryngol 1981;90(3 Pt 1):261-3.
- Brook I. Aerobic and anaerobic bacteriology of ade- noids in children: a comparison between patients with c h ronic adenotonsillitis and adenoid hypertro p h y. Laryngoscope 1981;91:377-82.
- Brook I, Pazzaglia G, Coolbaugh JC, Walker RI. In-vivo protection of group A beta-haemolytic streptococci f rom penicillin by beta-lactamase-pro d u c i n g Bacteroides species. J Antimicrob Chemother 1983;12: 599-606.
- Randolph MF, Redys JJ, Hibbard EW. Streptococcal pharyngitis. 3. Streptococcal recurrence rates follow- ing therapy with penicillin or with clindamycin (7- chlorolincomycin). Del Med J 1970;42:87-92.
- Brook I, Hirokawa R. Treatment of patients with a his- tory of recurrent tonsillitis due to group A beta- hemolytic streptococci. A prospective randomized study comparing penicillin, erythromycin, and clin- damycin. Clin Pediatr 1985;24:331-6.
- Kaplan EL, Johnson DR. Eradication of group A strep- tococci from the upper respiratory tract by amoxicillin with clavulanate after oral penicillin V treatment fail- ure. J Pediatr 1988;113:400-3.
- Brook I. Treatment of patients with acute recurrent tonsillitis due to group A beta-haemolytic streptococci: a prospective randomized study comparing penicillin and amoxycillin/clavulanate potassium. J Antimicrob Chemother 1989;24:227-33.
- Sclafani AP, Ginsburg J, Shah MK, Dolitsky JN. Treatment of symptomatic chronic adenotonsillar hypertrophy with amoxicillin/clavulanate potassium: short- and long-term results. Pediatrics 1998;101(4 Pt 1): 675-81.
- Bernstein JM, Sagahtaheri-Altaie S, Dryja DM, Wa c t a w s k i - Wende J. Bacterial interference in nasopharyngeal bacterial flora of otitis-prone and n o n - o t i t i s - p rone children. Acta Otorhinolaryngol Belg 1 9 9 4 ; 4 8 : 1 - 9 .
- Crowe CC, Sanders WE Jr, Longley S. Bacterial inter- ference. II. Role of the normal throat flora in preven- tion of colonization by group A Streptococcus. J Infect Dis 1973;128:527-32.
- Sanders E. Bacterial interference. I. Its occurre n c e among the respiratory tract flora and characterization of inhibition of group A streptococci by viridans strep- tococci. J Infect Dis 1969;120:698-707.
- Kielmovitch IH, Keleti G, Bluestone CD, Wald ER, Gonzalez C. Microbiology of obstructive tonsillar hyper- t rophy and re c u r rent tonsillitis. Arch Otolaryngol Head Neck Surg 1989;11 5 : 7 2 1 - 4 .
- B rook I, Gober AE. Bacterial interference in the nasopharynx following antimicrobial therapy of acute otitis media. J Antimicrob Chemother 1998;41: 4 8 9 - 9 2 .
- ISSN: 2602-4837
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1991
- Yayıncı: İstanbul Üniversitesi
Sayıdaki Diğer Makaleler
Nihat SUSAMAN, Şinasi YALÇIN, İrfan KAYGUSUZ, Turgut KARLIDAĞ, Üzeyir GÖK, Nevin İLHAN, İbrahim Hanifi ÖZERCAN
Rinofimanın lokal anestezi altında deri grefti ile tedavisi
Celil USLU, Rıza Murat KARAŞEN, M. Oğuz YENİDÜNYA
Kronik adenotonsillitli olgularda adenoid ve tonsil merkez kültürlerinin karşılaştırılması
Sinan KOCATÜRK, Armağan İNCESULU, Ünsal ERKAM, Tayfur DEMİRAY, Ebru KANDIRALI, Ali MERT
Orbital yayılımlı etmoid sinüs osteomu
Hülya KAHVE NOSHARİ, Tanju GÖKÇEER, Barış NAİBOĞLU, Asaf ATBAŞ