School of Medicine, University of Western Australia, Perth, WA, Australia.
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia.
Front Cell Infect Microbiol. 2022 Feb 28;12:831887. doi: 10.3389/fcimb.2022.831887. eCollection 2022.
The underlying pathogenesis of pediatric obstructive sleep disordered breathing (SDB) and recurrent tonsillitis (RT) are poorly understood but need to be elucidated to develop less invasive treatment and prevention strategies.
Children aged between 1- and 16-years undergoing adenoidectomy, tonsillectomy or adenotonsillectomy for SDB (n=40), RT alone (n=18), or both SDB and RT (SDB+RT) (n=17) were recruited with age-matched healthy controls (n=33). Total bacterial load and species-specific densities of nontypeable (NTHi) and were measured by qPCR in nasopharyngeal swabs, oropharyngeal swabs, adenoid and tonsillar tissue from children with SDB, SDB+RT and RT, and in naso- and oro- pharyngeal swabs from healthy children. A subset of tonsil biopsies were examined for biofilms using 16S rRNA FISH (n=3/group).
The 5 bacterial species were detected in naso- and oro- pharyngeal samples from all children. These species were frequently detected in adenotonsillar tissue (except , which was absent in adenoids) from children with SDB, SDB+RT and RT. NTHi and were observed in tonsils from 66.7-88.2% and 33.3-58.8% of children respectively. Similar total and species-specific bacterial densities were observed in adenotonsillar tissue from children with SDB, SDB+RT or RT. Nasopharyngeal and oropharyngeal swabs were more likely to have multiple bacterial species co-detected than adenotonsillar tissue where one or two targeted species predominated. Polymicrobial biofilms and intracellular bacteria were observed in tonsils from children with adenotonsillar disease.
Antimicrobials, particularly anti-biofilm therapies, may be a strategy for managing children with SDB.
儿童阻塞性睡眠呼吸障碍（SDB）和复发性扁桃体炎（RT）的潜在发病机制尚不清楚，但需要加以阐明，以制定出侵袭性更小的治疗和预防策略。
招募了年龄在 1 至 16 岁之间、因 SDB（n=40）、单独 RT（n=18）或 SDB+RT（n=17）而行腺样体切除术、扁桃体切除术或腺样体扁桃体切除术的儿童，以及年龄匹配的健康对照者（n=33）。使用 qPCR 测量了患有 SDB、SDB+RT 和 RT 的儿童的鼻咽拭子、口咽拭子、腺样体和扁桃体组织中的总细菌负荷和非典型（NTHi）和 特异性密度，以及健康儿童的鼻咽和口咽拭子中的细菌负荷和特异性密度。从扁桃体活检组织中观察了生物膜的 16S rRNA FISH（n=3/组）。
在所有儿童的鼻咽和口咽样本中均检测到了 5 种细菌。在患有 SDB、SDB+RT 和 RT 的儿童的腺样体扁桃体组织中经常检测到这些细菌（除 外，在腺样体中未检测到）。在 66.7-88.2%和 33.3-58.8%的儿童的扁桃体中分别观察到 NTHi 和 。在患有 SDB、SDB+RT 或 RT 的儿童的腺样体扁桃体组织中，观察到相似的总细菌密度和特定细菌密度。与腺样体扁桃体组织相比，鼻咽和口咽拭子更有可能检测到多种细菌共同存在，而腺样体扁桃体组织中则以一种或两种靶向细菌为主。在患有腺样体扁桃体疾病的儿童的扁桃体中观察到了混合生物膜和细胞内细菌。
抗生素，特别是抗生物膜疗法，可能是治疗 SDB 儿童的一种策略。
