Gaffney R J, Timon C I, Freeman D F, Walsh M A, Cafferkey M T
Department of Otalaryngology/Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland.
Respir Med. 1993 May;87(4):303-8. doi: 10.1016/0954-6111(93)90028-x.
The value of pernasal swabs and direct adenoid swabs in chronic adenoid and adenotonsillar disease was assessed in 175 patients. Prior to adenoidectomy (53 patients) or adenotonsillectomy (122 patients), pernasal and direct adenoid swabs were taken. Adenoid currettings and tonsil tissue were cultured. Haemophilus influenzae was the bacterium most frequently isolated from adenoid currettings and from the centre (core) of the resected tonsil. There was a close relationship between the bacteriology of the pernasal swab and the adenoid tissue and tonsil core in 72 and 71% of patients, respectively. There was an identical profile of pathogens in 52 and 49%, respectively. We suggest that in children with adenoiditis or adenotonsillitis and hypertrophy of the adenoid, a pernasal swab should be used in preference to a throat swab in selecting appropriate antimicrobial therapy. Penicillin and ampicillin are not appropriate blind therapy in chronic adenoid and adenotonsillar infections because of the prevalence of beta-lactamase-producing aerobes (40%) in adenoid and tonsil core in these conditions.
对175例患者评估了经鼻拭子和直接腺样体拭子在慢性腺样体及腺样体扁桃体疾病中的价值。在腺样体切除术（53例患者）或腺样体扁桃体切除术（122例患者）前，采集经鼻拭子和直接腺样体拭子。对腺样体刮除物和扁桃体组织进行培养。流感嗜血杆菌是从腺样体刮除物和切除扁桃体中心（核心）最常分离出的细菌。分别在72%和71%的患者中，经鼻拭子与腺样体组织以及扁桃体核心的细菌学之间存在密切关系。分别在52%和49%的患者中存在相同的病原体谱。我们建议，对于患有腺样体炎或腺样体扁桃体炎且腺样体肥大的儿童，在选择合适的抗菌治疗时，应优先使用经鼻拭子而非咽拭子。由于在这些情况下，腺样体和扁桃体核心中产β-内酰胺酶需氧菌的患病率为40%，青霉素和氨苄西林不适用于慢性腺样体及腺样体扁桃体感染的盲目治疗。
