Acute recurrent bacterial tonsillitis: Prospective, comparative and controlled study of its clinical and microbiological characterisitics

Abstract

Background: The acute recurrent tonsillitis is a frequent pathology, and it is one of the indications of tonsillectomy. The origen of this pathology is not well known. Aim: To identify the microbiology and susceptibility patterns of bacteria to antimicrobics of common use in acute recurrent bacterial tonsillitis (ARBT). Methods: A prospective, controlled and blind study was planned. Patients (“Cases”) with history of ARBT of surgical indication were evaluated. Inclusion criteria were the following: children of both sexes, between 4 and 10 years old, without immunodeficiency history, not receiving antibiotics for 15 days prior to surgery. “Controls” were defined as patients presenting with sleep apnea with surgical indication, without a history of ARBT or tonsillitis- suggesting symptoms for the past 6 months. In all patients the same technique was used to obtain a tissue sample for culture and antibiogram. For the sensibility study an antibiogram of the isolated strains was carried out and the presence of beta lactamases was evaluated. The data was analyzed using the S-plus software for univariate analysis. To evaluate proportions, the chi-square or the Fischer test were used. Continue variables were evaluated with the Wilcoxon Two Sample test. Results: There were no statistically significant differences in the strains found in Cases as compared to Controls. The most frequently found bacteria was Haemophilus influenzae in 26 samples of each group (81%), followed by S. Aureus and SBHGA. As to the more frequents pathogen associations, they were H. influenzae + S. aureus and H. influenzae+ SBHGA. Similarly, there were no statistically significant differences in the frequence of these associations between the SBHGA group and Controls. As for beta lactamases production, it was found that 7% of the Haemophilus influenzae strains of ARBT patients were beta lactamases (+). Among patients with tonsil hyperplasia, 12% of this bacteria strains were beta lactamase (+). These differences were not statistically significant (p=1).