Acharya A, Gurung R, Khanal B, Ghimire A
Department of Microbiology, BPKIHS, Dharan, Nepal.
JNMA J Nepal Med Assoc. 2010 Apr-Jun;49(178):139-42.
Peritonsillar abscess is a common complication of acute tonsillitis. Its management consists of aspiration or surgical drainage followed by appropriate antibiotics. Appropriate antibiotic treatment depends on the common organisms associated with infection and their antibiotic sensitivity pattern in local scenario.
Pus samples aspirated from diagnosed cases of peritonsillar abscess and submitted for culture and sensitivity in last two years were included in this study. Identification of different microorganisms was made on the basis of the microscopic findings, observation of their colony morphology and standard biochemical reactions. Susceptibility pattern to commonly used antibiotics were determined by Clinical Laboratory Standards Institute (CLSI) guidelines.
Altogether 24 pus samples were included in the study. Positive culture was obtained from 18 samples. Among them one organism was isolated from 13 samples whereas from five samples multiple organisms were isolated. From six samples no organisms could be cultured. Altogether Streptococcus pyogenes was isolated from 12 samples and Staphylococcus aureus from five samples. Other isolated organisms included Haemophlilus influenzae, Pseudomonas aeruginosa, Escherichia coli and Enterococcus species. Penicillin was effective for Streptococcus pyogenes whereas Staphylococcus aureus was resistant to it. Cloxacillin was found to be effective for Staphylococcus aureus. Ciprofloxacin and Ceftazidime were found to be effective for both organisms.
Streptococcus pyogenes and Staphylococcus aureus were more commonly associated with peritonsillar abscess. Streptococcus pyogenes were sensitive to penicillin but all Staphylococcus aureus were resistant to it. This fact should be considered in clinical practice for management of peritonsillar abscess.
扁桃体周脓肿是急性扁桃体炎的常见并发症。其治疗方法包括穿刺抽吸或手术引流，随后使用适当的抗生素。适当的抗生素治疗取决于与感染相关的常见病原体及其在当地情况下的抗生素敏感性模式。
本研究纳入了过去两年中从确诊的扁桃体周脓肿病例中抽吸的脓液样本，并将其送去进行培养和药敏试验。根据显微镜检查结果、菌落形态观察和标准生化反应来鉴定不同的微生物。采用临床实验室标准协会（CLSI）指南来确定对常用抗生素的敏感性模式。
本研究共纳入24份脓液样本。18份样本培养结果为阳性。其中，13份样本分离出一种微生物，5份样本分离出多种微生物。6份样本未培养出微生物。总共从12份样本中分离出化脓性链球菌，从五份样本中分离出金黄色葡萄球菌。其他分离出的微生物包括流感嗜血杆菌、铜绿假单胞菌、大肠杆菌和肠球菌属。青霉素对化脓性链球菌有效，而金黄色葡萄球菌对其耐药。发现氯唑西林对金黄色葡萄球菌有效。环丙沙星和头孢他啶对两种微生物均有效。
化脓性链球菌和金黄色葡萄球菌与扁桃体周脓肿的相关性更高。化脓性链球菌对青霉素敏感，但所有金黄色葡萄球菌均对其耐药。在扁桃体周脓肿的临床治疗中应考虑这一事实。
