Department of Otorhinolaryngology, Daugavpils Regional Hospital, LV-5401 Daugavpils, Latvia.
Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia.
Int J Mol Sci. 2022 Sep 7;23(18):10273. doi: 10.3390/ijms231810273.
Background: Despite the widespread use of antibiotics to treat infected tonsils, episodes of tonsillitis tend to recur and turn into recurrent tonsillitis (RT) or are complicated by peritonsillar abscesses (PTAs). The treatment of RT and PTAs remains surgical, and tonsillectomies are still relevant. Materials and methods: In a prospective, controlled study, we analyzed the bacteria of the tonsillar crypts of 99 patients with RT and 29 patients with a PTA. We performed the biofilm formation and antibacterial susceptibility testing of strains isolated from study patients. We compared the results obtained between patient groups with the aim to identify any differences that may contribute to ongoing symptoms of RT or that may play a role in developing PTAs. Results: The greatest diversity of microorganisms was found in patients with RT. Gram-positive bacteria were predominant in both groups. Candida species were predominant in patients with a PTA (48.3% of cases). Irrespective of patient group, the most commonly isolated pathogenic bacterium was S. aureus (in 33.3% of RT cases and in 24.14% of PTA cases). The most prevalent Gram-negative bacterium was K. pneumoniae (in 10.1% of RT cases and in 13.4% of PTA cases). At least one biofilm-producing strain was found in 37.4% of RT cases and in 27.6% of PTA cases. Moderate or strong biofilm producers were detected in 16 out of 37 cases of RT and in 2 out of 8 PTA cases. There was a statistically significant association found between the presence of Gram-positive bacteria and a biofilm-formation phenotype in the RT group and PTA group (Pearson χ2 test, p < 0.001). S. aureus and K. pneumoniae strains were sensitive to commonly used antibiotics. One S. aureus isolate was identified as MRSA. Conclusions: S. aureus is the most common pathogen isolated from patients with RT, and Candida spp. are the most common pathogens isolated from patients with a PTA. S. aureus isolates are susceptible to most antibiotics. Patients with RT more commonly have biofilm-producing strains, but patients with a PTA more commonly have biofilm non-producer strains. K. pneumoniae does not play a major role in biofilm production.
尽管抗生素被广泛用于治疗感染的扁桃体，但扁桃体炎发作往往会复发，变成复发性扁桃体炎（RT）或并发扁桃体周围脓肿（PTA）。RT 和 PTA 的治疗仍然是手术，扁桃体切除术仍然相关。
在一项前瞻性、对照研究中，我们分析了 99 例 RT 患者和 29 例 PTA 患者的扁桃体隐窝细菌。我们对从研究患者中分离的菌株进行了生物膜形成和抗菌药敏试验。我们比较了两组患者的结果，以确定任何可能导致 RT 持续症状或可能在形成 PTA 中发挥作用的差异。
在 RT 患者中发现了最多样化的微生物。两组中均以革兰氏阳性菌为主。念珠菌属在 PTA 患者中占优势（48.3%）。无论患者组如何，最常分离的致病菌都是金黄色葡萄球菌（在 33.3%的 RT 病例和 24.14%的 PTA 病例中）。最常见的革兰氏阴性菌是肺炎克雷伯菌（在 10.1%的 RT 病例和 13.4%的 PTA 病例中）。在 37.4%的 RT 病例和 27.6%的 PTA 病例中发现了至少一种产生物膜的菌株。在 16 例 RT 病例和 2 例 PTA 病例中检测到中度或强生物膜产生菌。RT 组和 PTA 组的革兰氏阳性菌和生物膜形成表型之间存在统计学显著关联（Pearson χ2 检验，p<0.001）。金黄色葡萄球菌和肺炎克雷伯菌对常用抗生素敏感。一株金黄色葡萄球菌被鉴定为耐甲氧西林金黄色葡萄球菌（MRSA）。
金黄色葡萄球菌是 RT 患者最常见的病原体，念珠菌属是 PTA 患者最常见的病原体。金黄色葡萄球菌分离株对大多数抗生素敏感。RT 患者更常见产生物膜的菌株，但 PTA 患者更常见非产生物膜的菌株。肺炎克雷伯菌在生物膜形成中不起主要作用。
