Jousimies-Somer H, Savolainen S, Mäkitie A, Ylikoski J
Anaerobe Reference Laboratory, National Public Health Institute, Helsinki, Finland.
Clin Infect Dis. 1993 Jun;16 Suppl 4:S292-8. doi: 10.1093/clinids/16.supplement_4.s292.
Aspirated pus samples from 124 patients with peritonsillar abscess were cultured quantitatively for aerobes and anaerobes. A total of 98% of the samples yielded bacteria. Of the 550 isolates obtained (mean, 4.4 per patient), 143 were aerobes (representing 16 species or groups) and 407 were anaerobes (representing 40 species or groups). Aerobes were isolated from 86% of patients-alone in 20 cases and together with anaerobes in 87. The most common aerobic isolates were Streptococcus pyogenes (isolated from 45% of patients), Streptococcus milleri group organisms (27%), Haemophilus influenzae (11%), and viridans streptococci (11%). Anaerobes were isolated from 82% of the samples and as a sole finding from 15 abscesses. Fusobacterium necrophorum and Prevotella melaninogenica were both isolated from 38% of patients, Prevotella intermedia from 32%, Peptostreptococcus micros from 27%, Fusobacterium nucleatum from 26%, and Actinomyces odontolyticus from 23%. The rate of previous tonsillar/peritonsillar infections was lowest (25%) among patients infected with S. pyogenes and highest (52%) among those infected with F. necrophorum (P < .01). Recurrences and/or related tonsillectomies were more common among patients infected with F. necrophorum than among those infected with S. pyogenes (57% vs. 19%; P < .0001) or with S. milleri group organisms (43% vs. 19%; P < .05). beta-Lactamase was produced by only 38% of the 73 isolates of Prevotella species tested; however, 56% of the 36 patients studied harbored one or more such strains.
对124例扁桃体周脓肿患者的吸出脓液样本进行需氧菌和厌氧菌的定量培养。总共98%的样本培养出细菌。在获得的550株分离菌中（平均每位患者4.4株），143株为需氧菌（代表16个菌种或菌群），407株为厌氧菌（代表40个菌种或菌群）。86%的患者分离出需氧菌，其中20例仅分离出需氧菌，87例同时分离出需氧菌和厌氧菌。最常见的需氧菌分离株为化脓性链球菌（从45%的患者中分离出）、米勒链球菌属菌群（27%）、流感嗜血杆菌（11%）和草绿色链球菌（11%）。82%的样本分离出厌氧菌，15例脓肿仅分离出厌氧菌。坏死梭杆菌和产黑色素普雷沃菌均从38%的患者中分离出，中间普雷沃菌从32%的患者中分离出，微小消化链球菌从27%的患者中分离出，具核梭杆菌从26%的患者中分离出，溶齿放线菌从23%的患者中分离出。既往扁桃体/扁桃体周感染率在感染化脓性链球菌的患者中最低（25%），在感染坏死梭杆菌的患者中最高（52%）（P<0.01）。坏死梭杆菌感染患者的复发和/或相关扁桃体切除术比化脓性链球菌感染患者（57%对19%；P<0.0001）或米勒链球菌属菌群感染患者（43%对19%；P<0.05）更常见。在所检测的73株普雷沃菌种分离株中，仅38%产生β-内酰胺酶；然而，在研究的36例患者中，56%携带一种或多种此类菌株。
