Bacteriology of chronic maxillary sinusitis in adults

Aspirates of 72 chronically inflamed maxillary sinuses were processed for aerobic and anaerobic bacteria. Bacterial growth was present in 66 of the 72 specimens (92%). Anaerobic bacteria were isolated in 58 of the 66 culture-positive specimens (88%). Anaerobes only were recovered in 37 cases (56%) and in 21 (32%) they were mixed with aerobic or facultative bacteria. Aerobic or facultative bacteria were present in eight cases (12%). A total of 185 isolates (2.8 per specimen)--131 (2.0 per specimen) anaerobes and 54 (0.8 per specimen) aerobes or facultatives--were isolated. The predominant anaerobic organisms were anaerobic cocci and Bacteroides sp, and the predominant aerobes or facultatives were Streptococcus sp and Staphylococcus aureus. Twelve of the 27 Bacteroides sp that were tested for beta-lactamase (44%) produced the enzyme. These findings indicate the major role of anaerobic organisms in chronic sinusitis.     

Bacteriology of antrum in adults with chronic maxillary sinusitis

Swabs of 126 chronically inflamed maxillary sinuses were processed for aerobic and anaerobic bacteria during endoscopy. Bacterial growth was present in 113 of 126 specimens (90%). Anaerobic bacteria were isolated in 100 of 113 culture-positive specimens (88%). Anaerobes only were recovered in 59 cases (52%) and, in 41 (36%), they were mixed with aerobic or facultative bacteria. Aerobic or facultative bacteria were present in 13 cases (12%). A total of 323 isolates (2.8 per specimen), 228 (2.3 per specimen) anaerobes and 95 (1.7 per specimen) aerobes or facultatives, were isolated. The predominant anaerobic organisms were anaerobic cocci and Bacteroides species; the predominant aerobes or facultative bacteria were Streptococcus species and Staphylococcus aureus. These findings indicate the major role of anaerobic organisms in chronic sinusitis.     

Bacteriology of chronic sinusitis and acute exacerbation of chronic sinusitis

OBJECTIVE: To establish the microbiological characteristics of acute exacerbation of chronic sinusitis (AECS). SETTING: Academic medical center. PATIENTS: Thirty-two patients with chronic sinusitis and 30 patients with AECS. MAIN OUTCOME MEASURE: The aerobic and anaerobic microbiology of maxillary AECS and chronic maxillary sinusitis. RESULTS: A total of 81 isolates (33 aerobic and 48 anaerobic) were recovered from the 32 cases (2.5 per specimen) with chronic sinusitis. Aerobes alone were recovered in 8 specimens (25%), anaerobes only were isolated in 11 (34%), and mixed aerobes and anaerobes were recovered in 13 (41%). The predominant aerobic and facultative bacteria were Enterobacteriaceae and Staphylococcus aureus. The predominant anaerobic bacteria were Peptostreptococcus subspecies, Fusobacterium subspecies, anaerobic gram-negative bacilli, and Propionibacterium acnes. Twenty-one beta-lactamase-producing bacteria were recovered from 17 specimens (53%). A total of 89 isolates (40 aerobic and facultatives, and 49 anaerobic) were recovered from the 30 patients (3.0 per specimen) with AECS. Aerobes were recovered in 8 instances (27%), anaerobes only in 11 (37%), and mixed aerobes and anaerobes were recovered in 11 (37%). The predominant aerobes were Streptococcus pneumoniae, Enterobacteriaceae, and S aureus. The predominant anaerobes were Peptostreptococcus subspecies, Fusobacterium subspecies, anaerobic gram-negative bacilli, and P acnes. Thirty-six beta-lactamase-producing bacteria were recovered from 28 specimens (53%). CONCLUSIONS: This study demonstrates that the organisms isolated from patients with AECS were predominantly anaerobic and were similar to those generally recovered in patients with chronic sinusitis. However, aerobic bacteria that are usually found in acute infections (eg, S pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis) can also emerge in some of the episodes of AECS.     

Microbiology of abscesses of the head and neck in children

Specimens from 36 children with abscesses of the neck and 31 children with abscesses of the head were cultured for aerobic and anaerobic bacteria. Antimicrobial therapy was administered to 51 of the 67 patients (76%) prior to sample collection. In specimens obtained from neck infections, aerobic bacteria only were recovered in 24 (67%), anaerobic bacteria only in seven (19%), and mixed aerobic and anaerobic bacteria in five (14%). In abscesses of the head, aerobic bacteria only were recovered in 11 (35%), anaerobic bacteria only in eight (26%), and mixed aerobic and anaerobic bacteria in 12 (39%). Of a total of 52 isolates recovered from neck abscesses (1.4 per specimen), 34 were aerobes (0.9 per specimen), and 18 were anaerobes (0.5 per specimen). Of a total of 62 isolates recovered from head abscesses (2.0 per specimen), 20 were aerobes (0.6 per specimen), and 42 were anaerobes (1.4 per specimen). The most frequently recovered organism in neck infection was Staphylococcus aureus (20 isolates), and the most frequently recovered organism in head infection was Bacteroides sp (19 isolates). beta-Lactamase activity was detected in 36 isolates recovered in 21 abscesses (46%). Correlation between the predisposing conditions and the bacteria recovered showed a higher recovery of anaerobes in patients with dental infection or manipulation, tonsillitis, and fetal monitoring. Staphylococcus aureus was associated with trauma. This study demonstrated the importance of anaerobic bacteria in abscesses in the head and neck, especially in infections originating from sites where these organisms are the predominant flora.     

Bacteriology of acute and chronic sphenoid sinusitis

Aspirates of 16 acutely infected and 7 chronically infected sphenoid sinuses were processed for aerobic and anaerobic bacteria. A total of 29 isolates were recovered from the 16 cases of acute sphenoid sinusitis (1.8 per specimen): 22 aerobic and facultative (1.4 per specimen), and 7 anaerobic (0.4 per specimen). Aerobic and facultative organisms alone were recovered in 10 specimens (62%), anaerobes alone were isolated in 3 (19%), and mixed aerobic and anaerobic bacteria were recovered in 3 (19%). The predominant aerobic and facultative species were Staphylococcus aureus (9 isolates), Streptococcus spp (9), and Haemophilus influenzae (2). A total of 28 isolates were recovered from the 7 cases of chronic sphenoid sinusitis (4.0 per specimen): 11 aerobic and facultative (1.6 per specimen) and 17 anaerobic (2.4 per specimen). Aerobic and facultative organisms alone were recovered in I instance (14%), anaerobes alone in 3 instances (43%), and mixed aerobes and anaerobes in 3 instances (43%). The predominant aerobic bacteria were gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa; 1 each). The predominant anaerobes included Peptostreptococcus spp (4 isolates), Prevotella spp (5), and Fusobacterium spp (4). These findings illustrate the unique microbiology of acute and chronic sphenoid sinusitis.     

Aerobic and anaerobic bacterial flora of normal maxillary sinuses

The bacterial flora of non-inflamed maxillary sinuses were studied in 12 adults. Patients' median age was 35 years (range 25 to 53 years): 8 were females and 4 were males. Aseptic aspiration of the sinus was made when the patients were under general anaesthesia for corrective plastic surgery of the nasal septum. All aspirates were cultured for aerobes and anaerobes. Anaerobes were isolated in all 12 specimen patients; in 5 patients (42%), they were the only organisms isolated, and in 7 (58%), they were recovered mixed with aerobes. There were 33 anaerobic isolates (2.75 pr specimen) and the predominant ones were: 11 Bacteroides sp. (including 6 B. melaninogenicus), 10 anaerobic gram-positive cocci and 5 Fusobacterium sp. There were 16 aerobic isolates (1.3 per specimen) and the predominant ones were: 5 beta hemolytic streptococci, 3 alpha hemolytic streptococci, and 2 each of S. pneumoniae and hemophilus parainfluenzae. Beta lactamase production was noted in 4 isolates recovered from 3 patients. These included all isolates of S. aureus (2) and 2 of 6 isolates of B. melaninogenicus. The presence of aerobic and anaerobic organisms in the non-inflamed sinus demonstrates the non-sterility of the sinus cavity. In the events that follow closure of the sinus ostium, these bacteria may become pathogenic.     

Microbiology of serous otitis media in children: correlation with age and length of effusion

The purpose of this study was to correlate the microbiology of serous otitis media in children with the duration of the condition and the patient's age. Aspirates of serous ear fluids from 114 children were examined for aerobic and anaerobic bacteria. Bacterial growth was noted in 47 patients (41%). Aerobic organisms only were recovered in 27 aspirates (57% of the culture-positive aspirates); anaerobic bacteria only in 7 (15%); and mixed aerobic and anaerobic bacteria in 13 (28%). A total of 83 bacterial isolates were recovered, accounting for 1.8 isolates per specimen (1.2 aerobes and 0.6 anaerobe). There were a total of 57 aerobic isolates, including Haemophilus influenzae (15 isolates), Streptococcus pneumoniae (13), and Staphylococcus sp (12). Twenty-six anaerobes were recovered, including anaerobic gram-positive cocci (10), Prevotella spp (8), and Propionibacterium acnes (4). The rate of positive cultures (20 of 36; 56%) was higher in patients younger than 2 years of age than in those older than 2 years of age (27 of 78; 35%). Streptococcus pneumoniae and H influenzae were more often isolated in children younger than 2 years of age and those with effusion for 3 to 5 months, whereas anaerobes were recovered more often in those older than 2 years of age and those with effusion for 6 to 13 months. These data illustrate the effects of the length of effusion and age on the recovery of aerobic and anaerobic bacteria in serous otitis media.     

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.     

Microbiology of acute and chronic maxillary sinusitis associated with an odontogenic origin

OBJECTIVES:: To study the microbiology of sinusitis associated with odontogenic origin. METHODS:: Aspirates of 20 acutely and 28 chronically infected maxillary sinuses that were associated with odontogenic infection were processed for aerobic and anaerobic bacteria. RESULTS:: A total of 66 isolates were recovered from the 20 cases of acute sinusitis (3.3/specimen), 16 aerobic and facultatives, and 50 anaerobic. Aerobes alone were recovered in 2 (10%) specimens, anaerobes only in 10 (50%), and mixed aerobic and anaerobic bacteria in 8 (40%). The predominant aerobic were alpha-hemolytic streptococci (5), microaerophilic streptococci (4), and Staphylococcus aureus (2). The predominant anaerobes were anaerobic Gram-negative bacilli (22), Peptostreptococcus (12), and Fusobacterium spp. (9). A total of 98 isolates were recovered from the 28 cases of chronic sinusitis (3.5/patient): 21 aerobic and facultatives and 77 anaerobic. Aerobes were recovered in 3 (11%) instances, anaerobes only in 11 (39%), and mixed aerobic and anaerobic bacteria in 14 (50%). The predominant aerobes were alpha-hemolytic streptococci (7), microaerophilic streptococci (4), and S. aureus (5). The predominant anaerobes were Gram-negative bacilli (41), Peptostreptococcus (16), and Fusobacterium spp. (12). Thirteen beta-lactamase-producing bacteria (BLPB) were recovered from 10 (50%) patients with acute sinusitis and 25 BLPB from 21 (75%) patients with chronic sinusitis. No correlation was found between the predisposing odontogenic conditions and the microbiological findings. CONCLUSIONS:: These data illustrate the similar microbiology of acute and chronic maxillary sinusitis associated with odontogenic infection where anaerobic bacteria predominate in both types of infections.     

Aerobic and anaerobic bacteriology of adenoids in children: A comparison between patients with chronic adenotonsillitis and adenoid hypertrophy

Adenoids were obtained from 18 children with chronic adenotonsillitis (Group A) and from 12 others with adenoid hypertrohy (Group B). Patients' ages ranged from 20 months to 15 years (means 6 years) 18 were males and 12 females. The adenoids were sectioned in half after heat searing of the surface, and the core material was cultured for aerobic and anaerobic microorganisms. Mixed aerobic and anaerobic flora were obtained from all patients, yielding an average of 7.8 isolates (4.6 anaerobes and 3.2 aerobes) per speciman. There were 97 anaerobes isolated. The predominant isolates in both groups were: Bacteroides sp. (including B. melaninogenicus and B. oralis), Fusobacterium sp., gram-positive anaerobic cocci, and Veillonella sp. There were 138 aerobic isolates. The predominant isolates in both groups were: alha and gamma hemolytic streptococci, beta hemolytic streptococci (Group A, B, C, and F), S. aureus, S. pneumoniae, and Hemophilus sp. Hemophilus infulenzae type B, and S. aureus were more frequently isolated in Group A. B. fragilis was only recovered in Group A. Beta lactamase production was noted in 27 isolates obtained from 18 patients. Fifteen of these patients belonged to Group A (83% of Group A), while 3 were members of Group B (25% of Group B). These bacteria were all isolates of S. aureus (11) and B. fragilis (2), 8 of 22 B, melaninogenicus group, 4 of 11 B. oralis, and two of 8 H. infulenzae type B. Our findings indicate the polymicrobial nature of deep adenoid flora and demonstrate the presence of many beta lactamase-producing organisms in children with recurrent adenotonsillitis.     

The role of anaerobic bacteria in otitis media: microbiology, pathogenesis, and implications on therapy

The current knowledge of the recovery of anaerobic bacteria from cases of acute and chronic otitis media is reviewed. Although techniques for cultivation of anaerobes were used in the studies presented, the methodologies of collection, transportation, and cultivation of the specimens varied. Consequently, there were differences in the rates of recovery of these organisms and the species isolated. Anaerobes, mainly gram-positive cocci, were recovered from a quarter of ear aspirates in acute otitis media in about one third mixed with aerobic and facultative bacteria. In a study of otitis media with effusion, anaerobic bacteria were recovered in 12% of the culture-positive aspirates. The predominant anaerobes were gram-positive cocci and Bacteroides melaninogenicus. Several studies reported the recovery of anaerobes in about half of the patients with chronic otitis media and in those with cholesteatoma. The predominant anaerobes were gram-positive cocci, Bacteroides sp, and Fusobacteria sp. Many of these organisms produced beta-lactamase and might have contributed to the failure of these patients to respond to penicillins. The potential synergistic relationships between the various aerobic and anaerobic bacteria and the role of the capsule of anaerobic bacteria as a virulence factor are discussed.     

Aerobic and anaerobic microbiology of acute suppurative parotitis

Aspirates of pus from acute suppurative parotitis were studied for aerobic and anaerobic bacteria. Bacterial growth was present in 23 specimens. A total of 36 bacterial isolates (20 anaerobic and 16 aerobic and facultative) were recovered, accounting for 1.6 isolates per specimen (0.9 anaerobic and 0.7 aerobic and facultative). Anaerobic bacteria only were present in 10 (43%) patients, aerobic and facultatives in 10 (43%), and mixed aerobic and anaerobic flora in 3 (13%). Single bacterial isolates were recovered in 9 infections, 6 of which were Staphylococcus aureus and 3 were anaerobic bacteria. The predominant bacterial isolates were S. aureus (8 isolates), Bacteroides sp. (6 isolates, including 4 Bacteroides melaninogenicus group), and Peptostreptococcus sp. (5). beta-Lactamase-producing organisms were recovered from 11 (73%) of the 15 specimens tested. This study highlights the polymicrobial nature and importance of anaerobic bacteria in acute suppurative parotitis.     

Microbiology of Cervical Lymphadenitis in Adults

The microbiology of needle aspirates from 40 inflamed cervical lymph glands was studied for aerobic and anaerobic bacteria, fungi and mycobacteria. Forty-two bacterial, 11 mycobacterial and six fungal isolates were isolated. Aerobic bacteria only were recovered in 11 (27.5%), anaerobes alone in five (12.5%) and mixed aerobic and anaerobic bacteria in seven (17.5%). Mycobacterium sp. were recovered in 11 (27.5%) and fungi in six (15%). The recovery of anaerobes was associated with dental infection. Eighteen aerobic bacteria were isolated and the predominant ones were Staphylococcus aureus (eight isolates) and group A streptococci (four). Twenty-four anaerobic bacteria were recovered and the predominant ones were: Prevotella sp. (six), Peptostreptococcus sp. (five), Propionibacterium acnes (four) and Fusobacterium sp. (three). These findings demonstrate the role of anaerobic organisms in cervical lymphadenitis and the need to culture aspirated material from the glands for both aerobic and anaerobic microorganisms.     

Bacteriology of infectious disease in otorhinolaryngology (1). Bacteriological study of paranasal cyst]

The bacteriology of chronic sinusitis has been reported in several studies, but there have been few bacteriological studies on paranasal cyst. Also, details of the techniques of transportation and processing of clinical specimens have only rarely been described. Therefore, this study was undertaken with attention to the above, and to obtain information on appropriate antimicrobial therapy, we conducted a dilution antimicrobial susceptibility test of isolates. Fifteen patients with paranasal cyst participated in this study. Their lesions were frontal sinus (3), ethmoid sinus (2), sphenoid sinus (2) and maxillary sinus (8). We punctured the cyst using an 18-gauge needle attached to a syringe at the time of operation, and paranasal cyst effusions were promptly transported to the laboratory. The specimen was immediately inoculated under a set of aerobic and prereduced anaerobic plates, which were incubated in appropriate conditions. Most specimens were completely processed within one hour. Antimicrobial susceptibility testing of isolates was done with MIC panel by the Sceptor system. Positive results of bacterial cultures were found in 60% of all cases (all of the frontal sinus specimens and half of those with other lesions). A total of 38 bacteria, including 24 anaerobic and 14 aerobic species, were isolated from 9 paranasal cysts, yielding an average of 4.2 species per positive case (2.9 anaerobes and 1.3 aerobes). Monomicrobial flora were found, anaerobes only in 2 cases and aerobes only in 2 others. Mixed flora were found in 5 cases in which both anaerobes and aerobes were isolated. The bacterial concentration in the maximal case was 4.9 x 10(4) CFU/ml. The organisms most frequently isolated were Propionibacterium spp. (7), Peptostreptococcus spp. (7), Staphylococcus spp. (7), Prevotella spp. (5) and Streptococcus spp. (4). On the basis of the results of antimicrobial susceptibility testing of isolates in vitro, the use of Cephems, Clavulanic acid/Amoxicillin, Norfloxacin and Chloramphenicol proved to be clinically effective.     

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.     

Bacteriology of acute and chronic frontal sinusitis

Aspirates of 15 acutely and 13 chronically infected frontal sinuses were processed for aerobic and anaerobic bacteria. A total of 20 isolates (1.3 per specimen) were recovered from the 15 cases of acute frontal sinusitis, 16 aerobic and facultative isolates (1.1 per specimen) and 4 anaerobic isolates (0.3 per specimen). Aerobic and facultative organisms alone were recovered in 13 specimens (87%), and mixed aerobic and anaerobic bacteria were recovered in 2 (13%). The predominant aerobic and facultative organisms were Haemophilus influenzae (6), Streptococcus pneumoniae (5), and Moraxella catarrhalis (3). A total of 32 isolates were recovered from the 13 cases (2.5 per patient) of chronic frontal sinusitis, 12 aerobic and facultative isolates (0.9 per specimen) and 20 anaerobic isolates (1.5 per specimen). Aerobic and facultative organisms only were recovered in 3 instances (23%), anaerobes only in 7 instances (54%), and mixed aerobic and anaerobic bacteria in 3 instances (23%). The predominant aerobic bacteria were gram-negative bacilli (H influenzae, Klebsiella pneumoniae, and Pseudomonas aeruginosa). The predominant anaerobes included Prevotella species (8), Peptostreptococcus species (6), and Fusobacterium species (4). These findings illustrate the microbiologic features of acute and chronic frontal sinusitis.     

The microbiology of mucopyocele.

OBJECTIVE: To evaluate the aerobic and anaerobic microbiology of mucopyocele. STUDY DESIGN: Retrospective review of clinical and microbiologic records of patients with mucopyocele between June 1982 and September 1997. METHODS: Aspirates of 36 mucopyocele were processed for aerobic and anaerobic bacteria. RESULTS: One hundred six bacterial isolates, 42 aerobic and facultatives and 64 anaerobic, were recovered. The predominant aerobic isolates were Staphylococcus aureus (6 isolates), alpha-hemolytic streptococci (6), Hemophilus spp. (5), and Gram-negative bacilli (6). The predominant anaerobes were Peptostreptococcus sp. (22), Prevotella sp. (15), Fusobacterium sp. (5), and Propionibacterium acnes(5). Thirty-three beta-lactamase-producing bacteria were isolated from 23 patients. CONCLUSIONS: These findings illustrate the polymicrobial aerobic and anaerobic bacteriology of mucopyocele.     

Microbial flora of surface versus core tonsillar cultures in recurrent tonsillitis in children

Surface and 'core' tonsillar specimens were collected from 60 children, between 2 and 14 years of age, suffering from recurrent tonsillitis, in order to establish the reliability of surface tonsillar swabbing technique and to define the most frequently involved aerobic and anaerobic microorganisms. From the qualitative point of view, the same mixed aerobic and anaerobic flora were obtained in both samples thus demonstrating the reliability of the surface swabbing technique. From the quantitative point of view, 187 microorganisms, 129 (69.2%) aerobes and 58 (30.8%) anaerobes were isolated from surface cultures while 184, 109 (59.2%) aerobes and 75 (40.8%) anaerobes from the core cultures, thus demonstrating a greater number of anaerobes in the core of the tonsil. The most common isolated aerobic microorganisms were the alpha- and beta-hemolytic Streptococci, the Neisseriae and the Staphylococcus aureus; the predominant anaerobic ones were the Fusobacterium nucleatum, the Bacteroides sp. and the Veillonella parvula. The isolated staphylococcus aureus and the bacteroides sp. were all beta-lactamase producers.     

Aerobic and anaerobic microbiology of peritonsillar abscess

Thirty-four aspirates of pus from peritonsillar abscesses that were studied for aerobic and anaerobic bacteria showed bacterial growth. A total 107 bacterial isolates (58 anaerobic and 49 aerobic and facultative) were recovered, accounting for 3.1 isolates per specimen (1.7 anaerobic and 1.4 aerobic and facultatives). Anaerobic bacteria only were present in 6 (18%) patients, aerobic and facultatives in 2 (6%), and mixed aerobic and anaerobic flora in 26 (76%). Single bacterial isolates were recovered in 4 infections, 2 of which were Streptococcus pyogenes and 2 were anaerobic bacteria. The predominant bacterial isolates were Staphylococcus aureus (6 isolates), Bacteroides sp (21 isolates, including 15 Bacteroides melaninogenicus group), and Peptostreptococcus sp (16) and S. pyogenes (10). beta-Lactamase-producing organisms were recovered from 13 (52%) of 25 specimens tested. This retrospective study highlights the polymicrobial nature and importance of anaerobic bacteria in peritonsillar abscess.     

Bacteriology of chronic tonsillitis in young adults

Tonsils were obtained from 22 young adults (mean age, 23 years) suffering from chronic tonsillitis. Mixed aerobic and anaerobic flora was obtained from core tonsillar cultures in all patients, yielding an average of 9.0 isolates (5.3 anaerobes and 3.7 aerobes) per specimen. The predominant anaerobic isolates were Bacteroides sp, Fusobacterium sp, and gram-positive cocci. The predominant aerobic isolates were alpha-hemolytic streptococci, Staphylococcus aureus, Branhamella catarrhalis, beta-hemolytic streptococci, and hemophilus sp. beta-Lactamase-production was noted in 32 isolates recovered from 18 tonsils (82%). These included all eight isolates of S aureus and five B fragilis, and 11 of 24 B melaninogenicus group (46%). Our findings indicate the polymicrobial nature of deep tonsillar flora in young adults with chronic tonsillitis, and demonstrate the presence of beta-lactamase-producing organisms in most of the patients.