Aerobic and anaerobic bacteriology of chronic adenoid disease in children

Bacterial cultures from nasopharyngeal swabs of children after adenoidectomy and from the removed adenoid tissue in the same patient group were compared. At the same time, the colony-forming unit, as a measure of viable bacterial cells and the composition of isolated bacteria were also determined in the case of adenoid tissue. Our findings showed that the culture results of nasopharyngeal swabs and inner part of the adenoid tissue are in close correlation. Polymicrobial aerobic-anaerobic flora was present in all instances. The predominant aerobic isolates in all two groups were S. pneumoniae, H. influenzae and M. catarrhalis. Anaerobic bacteria most commonly recovered in the adenoid were Peptostreptococcus spp., Prevotella spp., and Fusobacterium spp.     

Aerobic and anaerobic bacteriology of concurrent chronic otitis media with effusion and chronic sinusitis in children

OBJECTIVE: To correlate the aerobic and anaerobic microbiologic findings of concurrent chronic otitis media with effusion and chronic maxillary sinusitis. METHODS: Cultures were obtained from 32 children with concurrent chronic otitis media with effusion and maxillary sinusitis who underwent tympanostomy tube placement. RESULTS: A total of 42 isolates, 24 aerobic and 18 anaerobic, were recovered from 30 patients; 27 were isolated from both sites, 4 from the ear only, and 11 from the sinus only. The most common isolates were Haemophilus influenzae (9 isolates), Streptococcus pneumoniae (n = 7), Prevotella species (n = 8), and Peptostreptococcus species (n = 6). Microbiological concordance between the ear and sinus was found in 22 (69%) of culture-positive patients. CONCLUSION: The concordance in recovery of organisms in more than two thirds of the patients illustrates the common bacterial etiology between chronic otitis media with effusion and chronic sinusitis in children.     

Bacteriology of adenoids and tonsils in children with recurrent adenotonsillitis

Adenoids and tonsils electively removed from 25 children with a history of recurrent group A beta-hemolytic streptococci (GABHS) adenotonsillitis were cultured for aerobic and anaerobic bacteria. Two hundred twenty-four organisms (112 aerobes and facultatives, 110 anaerobes, and 2 Candida albicans) were isolated from the tonsils, and 229 (111 aerobes and facultatives and 118 anaerobes) were isolated from the adenoids. Mixed infection was present in all instances, with an average of 9.1 isolates per specimen. The predominant aerobes were Streptococcus sp, Haemophilus influenzae, and GABHS, and the prevalent anaerobes were Peptostreptococcus, Prevotella, and Fusobacterium spp. Beta-lactamase-producing bacteria were detected in 72 isolates recovered from 22 tonsils (88%) and in 74 isolates recovered from 21 adenoids (84%). Discrepancies in the organisms recovered were found between the tonsils and adenoids. Of the aerobic isolates, 20% were isolated only in tonsils and 18% only in adenoids. Of the anaerobes, 20% were found only in tonsils and 26% only in adenoids. This study demonstrates a polymicrobial aerobic-anaerobic flora in both adenoids and tonsils, and discrepancies in recovery of pathogens such as GABHS. The adenoids may serve as a potential source of tonsillitis caused by GABHS.     

Aerobic and anaerobic bacteriology of cholesteatoma

Cholesteatoma specimens were obtained from 28 patients undergoing surgery for chronic otitis media and cholesteatoma. All specimens were cultured for aerobic and anaerobic organisms. Bacterial growth was present in specimens of 24 of the 28 patients. A total of 74 bacterial isolates were present (40 aerobes and 34 anaerobes). Aerobes alone were isolated from 8 (33.3%) of culture positive patients, 4 patients (26.7%) yielded only anaerobes, and 12 (50%) had both aerobic and anaerobic bacteria. Fifty isolates (27 aerobes and 23 anaerobes) were present in a concentration > 10⁰ CFU/gm. The most commonly isolated aerobic organisms were P. aeruginosa (9), Proteus sp. (7), K. pneumoniae (5), S. aureus (5), and E. coli (4). The anaerobic bacteria most commonly isolated were gram-positive anaerobic cocci (12), Bacteroides sp. (12, including 5 B. fragilis group), Clostridium sp. (3), and Bifidobacterium sp. (3). The above findings indicate the polymicrobial aerobic and anaerobic bacteriology of cholesteatoma.     

儿童鼻窦炎与腺样体肥大的关系

儿童鼻窦炎发病率高,腺样体肥大是导致儿童鼻窦炎发病的重要原因之一。腺样体肥大可通过影响鼻腔发育、阻碍鼻腔引流和不断释放致病菌而持续影响鼻窦炎的发生发展,鼻窦炎则可通过炎症刺激导致腺样体肥大增生。变态反应因素可同时影响到鼻窦炎和腺样体炎症,是治疗儿童鼻窦炎和腺样体肥大时需要考虑的重要治疗靶点。腺样体与儿童鼻窦炎关系密切互为因果,而腺样体切除术可作为儿童鼻窦炎保守治疗效果不好时的首选外科治疗方案。     

Oxidants and antioxidants in tonsillar and adenoidal tissue in chronic adenotonsillitis and adenotonsillar hypertrophy in children

OBJECTIVE: The aim of the study is to determine the possible role of oxidants and antioxidants in the pathogenesis of chronic adenotonsillitis and adenotonsillar hypertrophy in children. PATIENTS AND METHODS: The children were divided into infection and hypertrophy groups, which were comparable according to age and gender distribution. The infection group was consisted of 20 children with the diagnosis of chronic adenotonsillitis and the hypertrophy group was made up of 19 children with adenotonsillar hypertrophy to whom adenotonsillectomy was performed. Preoperative blood levels of erythrocyte MDA, serum MDA, erythrocyte catalase and serum catalase, and adenoidal and tonsillar tissue levels of MDA and catalase were studied. RESULTS: There were significant increase in tonsil MDA, adenoid MDA, tonsil catalase and adenoid catalase levels in infection group (p<0.05). CONCLUSION: Oxidants and antioxidants are found to have an important role in the pathogenesis of adenotonsillar hypertrophy and chronic adenotonsillitis. These findings strengthen the hypothesis that indicates adenotonsillar hypertrophy and chronic adenotonsillitis are different diseases of the same tissues.     

腺样体肥大儿童合并慢性鼻窦炎的临床调查及相关性分析

目的　了解本地区腺样体肥大儿童合并慢性鼻窦炎的发病情况,并分析两者之间的相关性。方法　对178例确诊腺样体肥大患儿进行鼻窦CT三围扫描,明确合并慢 性鼻窦炎,进行判定,收集相关数据,行统计学分析。结果  178例腺样体肥大患儿,男107例,女71例,平均年龄7.3±2.5岁。合并慢性鼻窦炎者60例,占33.71%,二者在平均年龄、发病年龄及病程间比较均无显著性差异（P＞0.05）。鼻窦炎CT评分与A/N比值各等级之间比较,差异有统计学意义（r =0.435,P <0.05）。结论　腺样体肥大与慢性鼻窦炎CT评分之间有明显相关性,针对腺样体肥大治疗可明显减缓慢性鼻窦炎病情。     

儿童腺样体肥大与中耳咽鼓管功能相关性分析

目的:探讨腺样体大小与中耳功能和咽鼓管功能的相关性。方法:回顾性分析2004年2月~2004年10月因腺样体肥大收入院手术患儿的中耳功能,并比较腺样体肥大患儿和正常同龄儿童的咽鼓管功能的差异。结果:①腺样体大小与中耳压力有明显的负相关性(r=-0.41,P<0.05);②腺样体肥大患儿咽鼓管功能(13.9±13.2)daPa,与正常儿童咽鼓管功能(22.5±10.4)daPa比较,差异有统计学意义(t=-3.1,P<0.01);③患儿腺样体的大小程度与咽鼓管功能无明显相关性(r=-0.19,P>0.05)。结论:腺样体病理性肥大可引起咽鼓管功能障碍,是分泌性中耳炎(SOM)的发病基础。     

儿童腺样体肥大合并慢性鼻窦炎对分泌性中耳炎发生率的影响

目的探讨儿童腺样体肥大(AH)合并慢性鼻窦炎(CRS)对分泌性中耳炎(OME)发生率的影响。方法对我院2017年至2018年行腺样体切除术或腺样体扁桃体切除术的腺样体肥大患者的临床资料进行统计和分析,包括病史和体征,电子鼻咽镜检查,声阻抗测试以评估腺样体肥大患者分泌性中耳炎和慢性鼻窦炎的患病情况。并使用统计软件SPSS 24.0进行统计分析。结果在208例AH儿童中,有分泌性中耳炎的50例(24%),在学龄儿童(6~12岁)腺样体肥大患者中分泌性中耳炎的发生率最高。腺样体肥大组和腺样体肥大合并慢性鼻窦炎组之间分泌性中耳炎的发生率在统计学上有差异(P=0.001)。结论患有慢性鼻窦炎的腺样体肥大儿童患分泌性中耳炎的风险相应增加,而学龄期的腺样体肥大儿童分泌性中耳炎发生率最高。     

儿童腺样体肥大菌群分布Meta分析

目的　明确儿童腺样体肥大的菌群分布情况。方法　英文文献通过对PubMed、Embash和Medline数据库,中文文献通过对中国期刊全文数据库（CNKI）、中国科技期刊全文数据库（VIP）、万方数据库进行系统检索,收集各数据库自建库到2015年7月发表的所有儿童腺样体肥大细菌分布情况研究的文献。检索条件：英文检索词包括“adenoid”、“microbiology”、“bacteria”;中文检索词包括“腺样体”、“细菌”和“菌群”。结果　纳入研究的9篇文献共计1162份腺样体标本,流感嗜血杆菌检出率为0.21（95%CI ,0.09～0.32）,金黄色葡萄球菌检出率为0.14（95%CI,0.09～0.20）,肺炎链球菌检出率为0.15（95%CI,0.08～0.22）。结论　流感嗜血杆菌、金黄色葡萄球菌和肺炎链球菌是儿童腺样体肥大的菌群分布中3种主要的致病菌,为指导儿童腺样体肥大的诊疗提供了依据。     

Aerobic bacteriology of chronic suppurative otitis media without cholesteatoma in children.

Medical management of chronic suppurative otitis media without cholesteatoma in children was shown recently to be efficacious. We undertook a prospective study in order to determine 1) the organisms associated with the disease and their sensitivity to various antibiotics and 2) their association with clinical variables. Pseudomonas was isolated from 84% of the patients, enteric gram-negative bacilli from 32%, Staphylococcus aureus from 20%, streptococci from 14%, and Hemophilus influenzae from 15%. Pseudomonas aeruginosa was the sole isolate in 48 of the 128 patients (38%). The sensitivity of P aeruginosa (78 isolates) was 100% (of isolates) to mezlocillin and ciprofloxacin, 99% to tobramycin and ceftazidime, 97% to piperacillin, 94% to gentamicin, and 78% to ceftriaxone. The isolated organisms and their sensitivity to antibiotics were not associated with age, sex, duration of otorrhea, or the presence of granulation tissue or polyps. We believe that our data may contribute to the appropriate choice of antibiotics when nonsurgical management of chronic suppurative otitis media without cholesteatoma is considered.     

儿童腺样体肥大与分泌性中耳炎的相关性研究

目的分析儿童腺样体肥大伴分泌性中耳炎的发病情况及腺样体切除术后分泌性中耳炎的转归。方法1382例腺样体肥大的儿童行腺样体切除手术前后经鼻咽侧位片、声导抗检测及电测听检查,统计分析伴分泌性中耳炎发生率及其与腺样体肥大的关系。结果1382例中腺样体肥大合并分泌性中耳炎患者892耳,腺样体切除术后3个月复查,合并分泌性中耳炎患儿中治愈528耳（59.19%）,好转298耳（33.41%）,总有效率达92.60%。结论腺样体过度肥大是儿童分泌性中耳炎的一大诱因,鼻内镜下切除肥大腺样体治疗分泌性中耳炎,疗效明确,具有重要的临床意义。     

腺样体肥大儿童伴变应性鼻炎与分泌性中耳炎的相关性分析

目的 分析腺样体肥大儿童伴分泌性中耳炎(ＯＭＥ)与变应性鼻炎(ＡＲ)发病的相关性。方法 回顾性分析12岁以下870例腺样体肥大患儿的病史,分析AR、咽鼓管功能不良及OME的相关性。结果 本组腺样体肥大患儿中AR发病率为30.11%,AR在不同年龄组中的发病率差异有统计学意义,随着年龄增加,发病率逐渐升高(P<0.01)。6岁以内发生咽鼓管功能障碍及OME的概率高,其中1~3岁组发生分泌性中耳炎的概率最大(P<0.01)。春季OME发病率高(P<0.001)。与不伴AR患者相比,伴有AR患儿患咽鼓管功能不良的概率增加了0.4倍(P=0.042);但患有OME的检出率减少了32%(P=0.0472)。结论 在腺样体肥大患儿中,多种因素使咽鼓管功能不良乃至OME高发。其中咽鼓管及其周围结构生理、病理、发育特点是最主要的因素,变态反应是次要影响因素。随着年龄增长,前者因逐渐发育完善,致病性降低,后者致病性增高,但总的发病率是逐渐降低的。     

儿童慢性鼻窦炎合并腺样体肥大菌谱及预后相关因素分析

目的 分析慢性鼻窦炎(CRS)合并腺样体肥大患儿腺样体表面及鼻腔内细菌谱,比较腺样体手术对CRS的临床疗效及相关因素分析.方法 收集2017年10月—2019年10月就诊于北京儿童医院耳鼻咽喉科的30例CRS合并腺样体肥大患儿的相关临床资料,其中男22例,女8例.所有患儿均行腺样体和/或扁桃体切除术,术中采集腺样体表面...     

Otitis media in children: A prospective study of aerobic and anaerobic bacteriology

Tympanocentesis with aerobic and anaerobic cultivation of middle ear fluid was performed through one or both tympanic membranes of 186 children with acute otitis media. Aerobic bacteria alone, predominantly pneumococcus and Hemophilus influenzae, were isolated from 118 (63.4%) patients; and anaerobic organisms alone, most commonly Peptococcus, from 24 (12.9%). Twenty-six (14%) yielded mixtures of aerobes and anaerobes, and several had multiple aerobic or anaerobic agents. No bacterial growth was noted in 18 (9.7%) patients. The isolation of anaerobic bacteria alone, supported in some patients by Gram-stain observations of middle ear fluid, suggests that these bacteria, especially Peptococcus, may occasionally play a direct role in acute otitis media.     

鼻内镜下腺样体切除治疗儿童慢性咳嗽疗效分析

目的：方法:对慢性咳嗽儿童行鼻内镜检查,筛选出腺样体肥大并感染患儿39例,全麻下行鼻内镜下腺样体切除。结果：39例患儿中,29例痊愈,8例好转,2例手术前后无明显变化,转诊儿科,诊断咳嗽变异性哮喘（CVA）,收儿科治疗。 总有效率为95%。结论：对于腺样体肥大并常有感染的患儿,行鼻内镜下腺样体切除治疗继发性慢性咳嗽是合理和有效的。     

腺样体、扁桃体肥大患儿肺功能的改变及手术对其影响

目的 探讨腺样体、扁桃体肥大患儿肺功能的改变及手术对其影响.方法 选择因腺样体,扁桃体肥大住院手术患儿130例,采用MS-IOS肺功能仪检测其肺功能,并对术前肺功能异常的50例患儿术后随诊并再次行肺功能检测.采用呼吸阻抗(Zr)、共振频率(Rf),黏性阻力R5、R20,弹性阻力X5、X35,中心气道阻力(Rc)、外周气道阻力(Rp)等参数,分析不同程度腺样体、扁桃体肥大患儿以上参数的改变及手术前后的差异.结果 腺样体、扁桃体肥大患儿多数存在气道阻塞,Z5、R5、R20、X5、Rc、Rp等值偏高;但不同程度腺样体、扁桃体肥大患儿肺功能水平未见统计学差异(P＞0.05);与术前比较,患儿手术后气道阻塞程度明显减轻,表现为Z5、R5、R20等参数显著改善(P＜0.05).结论 腺样体、扁桃体肥大患儿多数存在气道阻塞,手术切除可明显减轻下气道阻塞程度.因此,对腺样体、扁桃体肿大患儿应早期干预,以消除对通气功能的影响.