Brook I, Yocum P, Foote P A
Department of Pediatrics, Georgetown University School of Medicine, Washington, D.C., USA.
Clin Infect Dis. 1995 Jul;21(1):171-6. doi: 10.1093/clinids/21.1.171.
Microbiological studies of the core of tonsils removed from children with recurrent tonsillitis due to group A beta-hemolytic streptococci were conducted during three periods, with 50 patients in each period: 1977-1978 (period 1), 1984-1985 (period 2), and 1992-1993 (period 3). Mixed flora were present in all tonsils, with 8.1 organisms per tonsil (3.8 aerobes and 4.3 anaerobes). The predominant isolates in each period were Staphylococcus aureus, Moraxella catarrhalis, Peptostreptococcus species, pigmented Prevotella species, Porphyromonas species, and Fusobacterium species. The rate of recovery of Haemophilus influenzae type b increased from 24% in period 1 to 76% in period 2 (P < .001); a decline to 12% in period 3 correlated with a concomitant increase in the frequency of recovery of non-type b strains of H. influenzae from 4% and 10% in periods 1 and 2, respectively, to 64% in period 3 (P < .001). Both the rate of recovery of beta-lactamase-producing bacteria and the number of these organisms per tonsil increased over time. Specifically, beta-lactamase-producing strains were detected in 37 tonsils (74%) during period 1, in 46 tonsils (92%) during period 2, and in 47 tonsils (94%) during period 3, and the number of such strains per tonsil increased from 1.1 in period 1 to 2.9 and 3.3 in periods 2 and 3, respectively.
对因A组β溶血性链球菌导致复发性扁桃体炎而接受扁桃体切除的儿童的扁桃体核心进行了微生物学研究，研究分三个阶段进行，每个阶段有50名患者：1977 - 1978年（第1阶段）、1984 - 1985年（第2阶段）和1992 - 1993年（第3阶段）。所有扁桃体中均存在混合菌群，每个扁桃体有8.1种微生物（3.8种需氧菌和4.3种厌氧菌）。每个阶段的主要分离菌为金黄色葡萄球菌、卡他莫拉菌、消化链球菌属、产色素普雷沃菌属、卟啉单胞菌属和梭杆菌属。b型流感嗜血杆菌的分离率从第1阶段的24%增至第2阶段的76%（P < .001）；第3阶段降至12%，这与非b型流感嗜血杆菌分离频率的相应增加相关，从第1阶段和第2阶段的4%和10%分别增至第3阶段的64%（P < .001）。产β-内酰胺酶细菌的分离率和每个扁桃体中此类微生物的数量均随时间增加。具体而言，第1阶段在37个扁桃体（74%）中检测到产β-内酰胺酶菌株，第2阶段在46个扁桃体（92%）中检测到，第3阶段在47个扁桃体（94%）中检测到，每个扁桃体中此类菌株的数量从第1阶段的1.1增至第2阶段的2.9和第3阶段的3.3。
