Bacteria Pattern Aerobic and Anaerobic From Surface Swab and Tonsillar Core Culture in Patients With Recurrent Tonsillitis

Dan Ginting, A. Rachman, L. Adenin, R. L. Kusumawati, Mirzan Hasibuan, Harry A. Asroel, Y. Herwanto
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Abstract

Backgrounds: Tonsillitis is the most common disease in otorhinolaryngology both acute and chronic, especially in children. Recurrent tonsillitis is a chronic inflammatory process in the palatine tonsils. Several studies have shown differences in pathogenic flora on surface and tonsillar core. This also causes an increase failure of eradicating germs in acute tonsillitis. Therefore, it falls into chronic stage. Identifying the bacterial organism in acute tonsillitis will guide appropriate antibiotic therapy that can revolutionize the management of chronic tonsillitis.Objectives: To determine the bacteria pattern from surface and tonsillar core in patients with recurrent tonsillitis. Methods: The research is a descriptive with cross sectional study. The sample of the study was patients with recurrent tonsillitis who underwent tonsillectomy surgery at Adam Malik General Hospital Medan and several satellite hospitals in Medan that met the inclusion criterias. Results:This study was attended by 33 recurrent tonsillitis subjects with more male(66,7%) and most of them below 20 years (66.7%).The most type of aerobic bacteria from surface and tonsillar core swabs was Staphylococcus aureus. Antibiotics that are still sensitive to Staphylococcus aureus in tonsillar core swabs are Gentamycin, Tigecycline, Clindamycin, and Inezolid. Antibiotics that are still sensitive to Staphylococcus aureus on surface smears are Tigecycline, Vancomycin, and Erythromycin. The bacteria form surface did not present bacteria from tonsillar core. The most anaerobic bacteria found on both ofthe surface and tonsillar core were Bacteroides fragilis.Conclusions:The swab cultures taken from the tonsillar surface may not always reveal the real pathogen of the tonsils. In addition, the estimated probability of tonsillar bacteriology by surface swabs varies with the type of the pathogen.
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复发性扁桃体炎患者表面拭子和扁桃体核心培养的好氧和厌氧细菌模式
背景:扁桃体炎是耳鼻喉科最常见的急慢性疾病,尤其是儿童。复发性扁桃体炎是腭扁桃体的慢性炎症过程。一些研究表明,扁桃体表面和扁桃体核心的致病菌群存在差异。这也会导致急性扁桃体炎的细菌根除失败增加。因此,它属于慢性阶段。识别急性扁桃体炎中的细菌有机体将指导适当的抗生素治疗,从而彻底改变慢性扁桃体炎的管理。目的:探讨复发性扁桃体炎患者扁桃体表面及扁桃体核的细菌分布。方法:采用描述性横断面研究。该研究的样本是在棉兰的亚当马利克综合医院和棉兰的几家符合纳入标准的卫星医院接受扁桃体切除术的复发性扁桃体炎患者。结果:本研究共纳入33例复发性扁桃体炎患者,其中男性居多(66.7%),年龄主要在20岁以下(66.7%)。体表和扁桃体核心拭子检出的需氧细菌以金黄色葡萄球菌最多。扁桃体核心拭子对金黄色葡萄球菌仍敏感的抗生素有庆大霉素、替加环素、克林霉素和伊奈唑胺。表面涂片上仍对金黄色葡萄球菌敏感的抗生素有替加环素、万古霉素和红霉素。细菌形态表面未见来自扁桃体核的细菌。扁桃体表面和扁桃体核心的厌氧菌以脆弱拟杆菌最多。结论:从扁桃体表面提取的拭子培养不一定能揭示扁桃体的真正病原体。此外,通过表面拭子估计扁桃体细菌学的概率随病原体的类型而变化。
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