Adenoid tissue: a comparative bacteriological study

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. 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. 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). 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.