Adenoid tissue: a comparative bacteriological study

Introduction: Adenoid hypertrophy and its complications such as otitis media and
sinusitis are common problems in childhood. Rapid and appropriate detection of
interfering microorganisms in chronic nasopharyngitis is very important for better
medical and surgical interventions. The aims of this study were to detect major core
adenoidal microorganisms and to compare similarity of pernasal and oropharyngeal
cultures with adenoidal culture, and also to compare bacteriological resistance in
patients with and without complications.
Methods: In this descriptive study, 50 patients with adenoid hypertrophy and
chronic nasopharyngitis were recruited and divided into 2 groups: group I (n=25)
with complications such as otitis media with effusion and group II (n=25)
without complication. All patients underwent adenoidectomy. A pressure
equalizing tube was inserted for patients in group I. The smear and culture
specimens were collected for bacteriological study.
Results: After 26 months of prospective bacteriological study on 50 patients with
adenoidal enlargement, major results were as follow: the most common adenoidal
growing microorganisms in two groups of patients, in decreasing frequency were
hemophilus influenza, type B beta hemolytic streptococcus and staphylococcus
auresus. Pernasal smear and culture results were more similar than oropharyngeal
results to core adenoidal cultures (p<0.01). 70.1% of adenoidal microorganisms
in group I patients and 21.2% in group II patients were resistant to ordinary
antibiotics (without anti-betalactamase activity) (P<0.0001).
Conclusion: For better medical management of chronic nasopharyngitis (pre and/or
post adenoidectomy), we recommend that in antibiotic selection, the hemophilus
influenza type B should be considered as the major growing organism. Pernasal
culturing is more appropriate for detection of interfering microorganisms. In
complicated patients (cases of otitis media with effusion and/or sinusitis) it is advisable
to use more potent antibiotics with anti-betalactamase activity. For infection control in
non-complicated patients, use of ordinary antibiotics can reduce the resistance to potent
antibiotics in general population