Microbiological Findings in Children with Adeno-Tonsillar Hypertrophy

Authors: J. Kraus 1;  M. Glasnák 2;  E. Nártová 3;  E. Pavlík 4;  J. Astl 5
Authors‘ workplace: ORL oddělení Nemocnice Rudolfa a Stefanie Benešov, a. s., primář MUDr. J. Kraus, Ph. D., MBA 1;  Oddělení klinické mikrobiologie Nemocnice Rudolfa a Stefanie Benešov, a. s., primář MUDr. M. Glasnák 2;  ORL klinika 3. LF UK a FN Královské Vinohrady, Praha, přednosta MUDr. M. Chovanec, Ph. D. 3;  Ústav imunologie a mikrobiologie 1. LF UK a VFN, Praha, přednosta prof. MUDr. I. Šterzl, CSc. 4;  ORL klinika 3. LF UK a ÚVN, Praha, přednosta prof. MUDr. J. Astl, CSc. 5
Published in: Otorinolaryng. a Foniat. /Prague/, 65, 2016, No. 1, pp. 18-23.
Category: Original Papers


The exact cause of adenotonsillar hypertrophy is not clear, but association with chronic or recurrent infection and thus with microbiologic findings in the pharynx is accounted. Pharyngeal flora contains a wide range of bacteria, including commensals and also potential pathogens. The aim of the study was to determine the microbiological profile of the upper respiratory and digestive tract in children with sleep related disorders caused by adenotonsillar hypertrophy and the potential relevance of bacterial colonization for the development of the disease. The research included commonly occurring flora, obligate and potential pathogens. Susceptibility to antibiotics was tested in positive cases.

Material and methods:
A group of 37 children with adenotonsillar hypertrophy indicated for surgery were followed in a prospective study. At the beginning of each surgical procedure the sample of tissue was taken. A total of 49 samples was collected, 32 from adenoids and 17 from tonsils. All samples were examined for the presence of common pharyngeal pathogens.

The most common microbiological finding was normal bacterial flora that means normal bacterial colonization of the mucous membranes. But nearly two-thirds of the samples contained a potential pathogen. The most frequently present bacteria were Streptococcus pyogenes group A, beta-hemolytic Streptococci group C and Staphylococcus aureus. All strains of beta-hemolytic Streptococci have been well sensitive to penicillin. The resistance to erythromycin has been detected in twenty percent. The strains of Staphylococcus aureus have revealed good susceptibility to cefoxitin and co-trimoxazol.

Microbiological profile of common bacteria in the pharynx with adenotonsillar hypertrophy is not different from the findings in healthy subjects. Limited effect of antibiotics and good efficacy of surgery may be explained by the forming of biofilms on the mucous surface. The territorial status of antibiotic resistance is still favorable.

adenoidectomy, tonsillectomy, children, adenotonsillar hypertrophy, bacterial flora, pharynx


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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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