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Clapperton M, Kunanandam T, Florea CD, Douglas CM, McConnell G. Multimodal optical mesoscopy reveals the quantity and spatial distribution of Gram-positive biofilms in ex vivo tonsils. J Microsc 2024; 295:121-130. [PMID: 38296824 DOI: 10.1111/jmi.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 02/02/2024]
Abstract
Biofilms are known to be present in tonsils, but little is known about their spatial location and size distribution throughout the tonsil. Studies of the location and distribution of biofilms in tonsil specimens have thus far been limited to either high-magnification methods such as electron microscopy, which enables high-resolution imaging but only from a tiny tissue volume, or lower magnification techniques such as light microscopy, which allow imaging of larger specimens but with poor spatial resolution. To overcome these limitations, we report the use of multimodal optical mesoscopy to visualise and quantify the number and spatial distribution of Gram-positive biofilms in fresh, excised paediatric tonsils. This methodology supports simultaneous imaging of both the tonsil host and biofilms in whole mounts of tissue up to 5 mm × 5 mm × 3 mm with subcellular resolution throughout. A quantitative assessment of 36 tonsil specimens revealed no statistically significant difference between biofilm presence on the tonsil surface and the interior of the tonsil. This new quantitative mesoscale imaging approach may prove useful in understanding the role of biofilms in tonsillar diseases and other infections.
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Affiliation(s)
- Megan Clapperton
- Department of Physics, SUPA, University of Strathclyde, Glasgow, UK
| | - Tash Kunanandam
- Department of Otolaryngology - Head and Neck Surgery, Royal Hospital for Children, Glasgow, UK
| | - Catalina D Florea
- Department of Otolaryngology - Head and Neck Surgery, Royal Hospital for Children, Glasgow, UK
| | - Catriona M Douglas
- Department of Otolaryngology - Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Gail McConnell
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
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2
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Ghosh Moulic A, Deshmukh P, Gaurkar SS. A Comprehensive Review on Biofilms in Otorhinolaryngology: Understanding the Pathogenesis, Diagnosis, and Treatment Strategies. Cureus 2024; 16:e57634. [PMID: 38707023 PMCID: PMC11070220 DOI: 10.7759/cureus.57634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Biofilms, structured communities of microorganisms encased in a self-produced matrix, pose significant challenges in otorhinolaryngology due to their role in chronic and recurrent infections affecting the ear, nose, and throat (ENT) region. This review provides an overview of biofilms, emphasizing their formation, pathogenesis, diagnosis, and treatment strategies in otorhinolaryngological disorders. Biofilms are pivotal in chronic rhinosinusitis (CRS), otitis media, laryngopharyngeal reflux (LPR), and tonsillitis, contributing to treatment resistance and disease recurrence. Current diagnostic techniques, including imaging modalities, microbiological cultures, and molecular techniques, are discussed, alongside emerging technologies. Treatment strategies, ranging from conventional antibiotics to alternative therapies, such as biofilm disruptors, phage therapy, and immunomodulation, are evaluated in terms of their efficacy and potential clinical applications. The review underscores the significance of understanding biofilms in otorhinolaryngology and highlights the need for tailored approaches to diagnosis and management to improve patient outcomes.
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Affiliation(s)
- Ayushi Ghosh Moulic
- Otorhinolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Prasad Deshmukh
- Otorhinolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Sagar S Gaurkar
- Otorhinolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Katundu DR, Chussi D, van der Gaast-de Jongh CE, Rovers MM, de Jonge MI, Hannink G, van Heerbeek N. Bacterial colonisation of surface and core of palatine tonsils among Tanzanian children with recurrent chronic tonsillitis and obstructive sleep apnoea who underwent (adeno)tonsillectomy. J Laryngol Otol 2024; 138:89-92. [PMID: 37332170 PMCID: PMC10772025 DOI: 10.1017/s0022215123001147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/13/2023] [Accepted: 05/30/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Acute and chronic tonsillitis are frequently treated with antibiotics. This study aimed to understand the presence of pathogenic micro-organisms on the surface and core of chronically infected tonsils among Tanzanian children. METHODS The study enrolled children undergoing adenotonsillectomy. Surface and core tonsillar swabs were taken. Quantitative polymerase chain reaction was performed for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, Neisseria meningitidis and Pseudomonas aeruginosa. RESULTS Surface and core combined, isolated N meningitidis (86.1 per cent) was found the most, followed by H influenzae (74.9 per cent), S pneumoniae (42.6 per cent) and S aureus (28.7 per cent). M catarrhalis and P aeruginosa were only found in a few patients, 5.6 per cent and 0.8 per cent respectively. CONCLUSION Colonisation of the tonsillar surface and core has been found. Potentially pathogenic micro-organisms are likely to be missed based on a throat swab. Hence, the practice of surface tonsillar swabbing may be misleading or insufficient.
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Affiliation(s)
- Denis R Katundu
- Department of Otolaryngology, Kilimanjaro Christian Medical Centre, Kilimanjaro, Tanzania
- Department of Otolaryngology, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
- Department of Otolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Desderius Chussi
- Department of Otolaryngology, Kilimanjaro Christian Medical Centre, Kilimanjaro, Tanzania
- Department of Otolaryngology, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Christa E van der Gaast-de Jongh
- Department of Laboratory Medicine, Laboratory of Immunology, Radboud Centre for Infectious Diseases, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maroeska M Rovers
- Department of Medical Imaging, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marien I de Jonge
- Department of Laboratory Medicine, Laboratory of Immunology, Radboud Centre for Infectious Diseases, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gerjon Hannink
- Department of Medical Imaging, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Niels van Heerbeek
- Department of Otolaryngology, Kilimanjaro Christian Medical Centre, Kilimanjaro, Tanzania
- Department of Otolaryngology, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
- Department of Otolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
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Current bacteriological profile of tonsillar surface versus core tissue in patients undergoing tonsillectomy. Indian J Med Microbiol 2022; 42:77-81. [PMID: 36464533 DOI: 10.1016/j.ijmmb.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE The current study explored the bacteriological profile in the tonsillar core in patients undergoing tonsillectomy and compared it with tonsillar surface organisms. The antibiotic sensitivity and resistance patterns were also studied. MATERIALS AND METHODS This prospective and observational study was conducted in the Department of Otorhinolaryngology, Head and Neck surgery in a tertiary care institute, on a total of sixty-one patients clinically diagnosed as chronic tonsillitis and undergoing tonsillectomy. Tonsillar surface culture swabs and core tissue specimen were sent in separate vials. The culture isolates and their antibiotic sensitivity were analysed and compared. RESULTS Bacterial growth was detected in 61% of the cases, in cultures from the surface or the core tissue or both. 50.8% specimens of core tissue versus 31.1% of tonsillar surface samples revealed bacterial growth. Of the 13 cases in which surface and core both had bacterial culture growth, the same pathogens were identified in 8 cases. Pseudomonas aeruginosa was the most commonly reported organism in both tonsillar core as well as surface swab cultures. CONCLUSION Our study shows that surface swab culture is not always a reliable indicator of organisms present in core of tonsils in cases of chronic infection. The surface swabs did not always match the pathogens in the core. The higher prevalence and the variability of pathogenic organisms in the core tissue as compared to the surface suggests that a targeted antibiotic treatment based on surface culture swabs is unlikely to eradicate them.
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Klagisa R, Racenis K, Broks R, Balode AO, Kise L, Kroica J. Analysis of Microorganism Colonization, Biofilm Production, and Antibacterial Susceptibility in Recurrent Tonsillitis and Peritonsillar Abscess Patients. Int J Mol Sci 2022; 23:ijms231810273. [PMID: 36142185 PMCID: PMC9499404 DOI: 10.3390/ijms231810273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/30/2022] [Accepted: 09/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Despite the widespread use of antibiotics to treat infected tonsils, episodes of tonsillitis tend to recur and turn into recurrent tonsillitis (RT) or are complicated by peritonsillar abscesses (PTAs). The treatment of RT and PTAs remains surgical, and tonsillectomies are still relevant. Materials and methods: In a prospective, controlled study, we analyzed the bacteria of the tonsillar crypts of 99 patients with RT and 29 patients with a PTA. We performed the biofilm formation and antibacterial susceptibility testing of strains isolated from study patients. We compared the results obtained between patient groups with the aim to identify any differences that may contribute to ongoing symptoms of RT or that may play a role in developing PTAs. Results: The greatest diversity of microorganisms was found in patients with RT. Gram-positive bacteria were predominant in both groups. Candida species were predominant in patients with a PTA (48.3% of cases). Irrespective of patient group, the most commonly isolated pathogenic bacterium was S. aureus (in 33.3% of RT cases and in 24.14% of PTA cases). The most prevalent Gram-negative bacterium was K. pneumoniae (in 10.1% of RT cases and in 13.4% of PTA cases). At least one biofilm-producing strain was found in 37.4% of RT cases and in 27.6% of PTA cases. Moderate or strong biofilm producers were detected in 16 out of 37 cases of RT and in 2 out of 8 PTA cases. There was a statistically significant association found between the presence of Gram-positive bacteria and a biofilm-formation phenotype in the RT group and PTA group (Pearson χ2 test, p < 0.001). S. aureus and K. pneumoniae strains were sensitive to commonly used antibiotics. One S. aureus isolate was identified as MRSA. Conclusions: S. aureus is the most common pathogen isolated from patients with RT, and Candida spp. are the most common pathogens isolated from patients with a PTA. S. aureus isolates are susceptible to most antibiotics. Patients with RT more commonly have biofilm-producing strains, but patients with a PTA more commonly have biofilm non-producer strains. K. pneumoniae does not play a major role in biofilm production.
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Affiliation(s)
- Renata Klagisa
- Department of Otorhinolaryngology, Daugavpils Regional Hospital, LV-5401 Daugavpils, Latvia
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia
- Correspondence: ; Tel.: +371-28471191
| | - Karlis Racenis
- Department of Biology and Microbiology, Riga Stradins University, LV-1007 Riga, Latvia
- Center of Nephrology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Renars Broks
- Department of Biology and Microbiology, Riga Stradins University, LV-1007 Riga, Latvia
| | - Arta Olga Balode
- Department of Microbiology, NMS Laboratory, LV-1039 Riga, Latvia
| | - Ligija Kise
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia
| | - Juta Kroica
- Department of Biology and Microbiology, Riga Stradins University, LV-1007 Riga, Latvia
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Bergmeier LA, Dutzan N, Smith PC, Kraan H. Editorial: Immunology of the Oral Mucosa. Front Immunol 2022; 13:877209. [PMID: 35401502 PMCID: PMC8992007 DOI: 10.3389/fimmu.2022.877209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/04/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Lesley Ann Bergmeier
- Centre for Immunobiology and Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Nicolas Dutzan
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Patricio C Smith
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Heleen Kraan
- Institute for Translational Vaccinology, Intravacc, Bilthoven, Netherlands
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Mateus T, Seppanen EJ, de Gier C, Clark S, Coates H, Vijayasekaran S, Prosser K, Wiertsema SP, Fuery A, Kirkham LAS, Richmond PC, Thornton RB. Sleep Disordered Breathing and Recurrent Tonsillitis Are Associated With Polymicrobial Bacterial Biofilm Infections Suggesting a Role for Anti-Biofilm Therapies. Front Cell Infect Microbiol 2022; 12:831887. [PMID: 35295756 PMCID: PMC8918577 DOI: 10.3389/fcimb.2022.831887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe underlying pathogenesis of pediatric obstructive sleep disordered breathing (SDB) and recurrent tonsillitis (RT) are poorly understood but need to be elucidated to develop less invasive treatment and prevention strategies.MethodsChildren aged between 1- and 16-years undergoing adenoidectomy, tonsillectomy or adenotonsillectomy for SDB (n=40), RT alone (n=18), or both SDB and RT (SDB+RT) (n=17) were recruited with age-matched healthy controls (n=33). Total bacterial load and species-specific densities of nontypeable Haemophilus influenzae (NTHi), Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Moraxella catarrhalis were measured by qPCR in nasopharyngeal swabs, oropharyngeal swabs, adenoid and tonsillar tissue from children with SDB, SDB+RT and RT, and in naso- and oro- pharyngeal swabs from healthy children. A subset of tonsil biopsies were examined for biofilms using 16S rRNA FISH (n=3/group).ResultsThe 5 bacterial species were detected in naso- and oro- pharyngeal samples from all children. These species were frequently detected in adenotonsillar tissue (except S. aureus, which was absent in adenoids) from children with SDB, SDB+RT and RT. NTHi and S. aureus were observed in tonsils from 66.7-88.2% and 33.3-58.8% of children respectively. Similar total and species-specific bacterial densities were observed in adenotonsillar tissue from children with SDB, SDB+RT or RT. Nasopharyngeal and oropharyngeal swabs were more likely to have multiple bacterial species co-detected than adenotonsillar tissue where one or two targeted species predominated. Polymicrobial biofilms and intracellular bacteria were observed in tonsils from children with adenotonsillar disease.ConclusionsAntimicrobials, particularly anti-biofilm therapies, may be a strategy for managing children with SDB.
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Affiliation(s)
- Tulia Mateus
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Elke J. Seppanen
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Camilla de Gier
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Sharon Clark
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Harvey Coates
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Shyan Vijayasekaran
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Perth Children’s Hospital, Perth, WA, Australia
| | | | - Selma P. Wiertsema
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Angela Fuery
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Lea-Ann S. Kirkham
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Peter C. Richmond
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- Perth Children’s Hospital, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Ruth B. Thornton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
- *Correspondence: Ruth B. Thornton,
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Gurov AV, Dubovaya TK, Ermolaev AG, Murzakhanova ZV, Makhmudova NR, Dombalagyan AK. [Possibilities of modern forms of antimicrobial peptides in the treatment of inflammatory pathology of the pharynx]. Vestn Otorinolaringol 2022; 87:43-49. [PMID: 36404690 DOI: 10.17116/otorino20228705143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Inflammatory diseases of the pharynx occupy one of the leading places in the structure of otorhinolaryngological pathology. Acute and chronic inflammatory processes in the pharynx, as well as exacerbations of the latter, are faced by doctors of a wide range of specialties. Oropharyngeal swab laboratory testing is required to identify a specific pathogen, which takes time. In this regard, of particular interest are local drugs with the necessary spectrum of action, the use of which is possible, both as monotherapy and in combination with systemic therapy. The combination of tyrothricin (tyrothricin), benzalkonium chloride (benzalkonium chloride), and benzocaine (benzocaine) (dorithricin) is highly effective in the treatment of bacterial, viral and fungal infections of the pharynx, and microorganisms consistently demonstrate high sensitivity to the components of the drug.
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Affiliation(s)
- A V Gurov
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - T K Dubovaya
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A G Ermolaev
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Z V Murzakhanova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N R Makhmudova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A Kh Dombalagyan
- Pirogov Russian National Research Medical University, Moscow, Russia
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Klagisa R, Kroica J, Kise L. S. aureus and K. pneumoniae on the Surface and within Core of Tonsils in Adults with Recurrent Tonsillitis. MEDICINA-LITHUANIA 2021; 57:medicina57101002. [PMID: 34684039 PMCID: PMC8539365 DOI: 10.3390/medicina57101002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/02/2022]
Abstract
Background and Objectives: Recurrent tonsillitis is an infection of the palatine tonsils. Samples for microbiological testing are usually obtained from the inflamed surface of the tonsils. Colonizing the surface bacteria does not always correlate with pathogens causing recurrent tonsillitis and there is no consensus or this in research studies. The aim of the study was to compare whether Staphylococcus aureus (S. aureus) and Klebsiella pneumoniae (K. pneumoniae) differ when isolated from the tonsillar surface or tonsillar crypts in patients with recurrent tonsillitis. Materials and Methods: a case series study was conducted at a tertiary referral center among 25 patients diagnosed with recurrent tonsillitis. An evaluation of S. aureus and K. pneumoniae incidence, biofilm formation and antibacterial susceptibility was performed. Results: There was a statistically significant association between surface and punch biopsy samples for S. aureus (Fisher’s Exact test p = 0.004) and K. pneumoniae (Fisher’s Exact test p < 0.001). A McNemar test did not reveal a statistically significant association. Although the antibacterial resistance profile was not broad, five out of nine S. aureus isolates were biofilm producers and four out of five K. pneumoniae isolates were biofilm producers. Conclusions: Surface and core cultures of tonsils are comparable with a differing incidence between the surface and the punch biopsy cultures for S. aureus and K. pneumoniae. A larger quantity of bacteria exist in surface samples suggesting that a biopsy sample may be less challenging in evaluating recurrent tonsillitis. We recommend that antibacterial susceptibility results are considered alongside the biofilm-forming potential of isolated bacteria.
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Affiliation(s)
- Renata Klagisa
- Department of Otorhinolaryngology, Riga Stradins University, LV-1007 Riga, Latvia
- Department of Otorhinolaryngology, Daugavpils Regional Hospital, LV-5401 Daugavpils, Latvia
- Correspondence: ; Tel.: +371-2-847-1191
| | - Juta Kroica
- Department of Biology and Microbiology, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Ligija Kise
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia;
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10
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Li S, Xie H, Chiang HJ, Liu Z, Han Z, Liang J, Wang L, Wang Q, Li J, Li Y. Effectiveness of TCM cauterization in recurrent tonsillitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22597. [PMID: 33031313 PMCID: PMC10545315 DOI: 10.1097/md.0000000000022597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Recurrent tonsillitis (RT) is often treated with antibiotic therapy and surgery. Although these treatments have advantages, they are also controversial. The purpose of this study is to analyze the safety and effectiveness of traditional Chinese medicine (TCM) cauterization in the treatment of RT, so as to provide an alternative for the clinicians and to cover the shortage of therapeutic methods. METHODS AND ANALYSIS This protocol is guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. We will formulate strict inclusion and exclusion criteria in English databases (PubMed, EMBASE, and Web of Science), Chinese databases (CNKI, Wanfang databases, CBM, and VIP), and search literatures in different clinical registration platforms (Cochrane Library, Chinese Cochrane Centre's Clinical Trial Registry Platform). The included articles will be evaluated using Cochrane RCT evaluation criteria. Stata 15.0 will be used for data analysis. Subgroup analysis, sensitivity analysis, and meta-regression will detect sources of heterogeneity. Egger's Test or Begg's Test will detect publication bias quantitatively. CONCLUSION Cauterization can effectively control the recurrence of tonsillitis through clinical trials, but evidence-based medicine needs to be adopted to provide strong evidence for its effectiveness. The purpose of our research is to provide the evidence. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/PZ69Q.
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Affiliation(s)
- Sha Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Hui Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Han-Jen Chiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Zhiqing Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Zhenzhen Han
- Yibin Hospital of T.C.M, West of South Bank District, Yibin City, Sichuan Province, P.R. China
| | - Jiao Liang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Lu Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Qiu Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Jiongke Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Yusi Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu
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Identification and Detection of Pathogenic Bacteria in Adenoid Tissue of Adenoidectomized Children: Emergence of Staphylococcus aureus as the Most Prevalent Pathogen. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.95445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Mirzaei R, Mohammadzadeh R, Alikhani MY, Shokri Moghadam M, Karampoor S, Kazemi S, Barfipoursalar A, Yousefimashouf R. The biofilm‐associated bacterial infections unrelated to indwelling devices. IUBMB Life 2020; 72:1271-1285. [DOI: 10.1002/iub.2266] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Rasoul Mirzaei
- Department of Microbiology, School of MedicineHamadan University of Medical Sciences Hamadan Iran
| | - Rokhsareh Mohammadzadeh
- Department of Microbiology, School of MedicineIran University of Medical Sciences Tehran Iran
| | - Mohammad Yousef Alikhani
- Department of Microbiology, School of MedicineHamadan University of Medical Sciences Hamadan Iran
| | | | - Sajad Karampoor
- Department of Virology, School of MedicineIran University of Medical Sciences Tehran Iran
| | - Sima Kazemi
- Department of Microbiology, School of MedicineHamadan University of Medical Sciences Hamadan Iran
| | | | - Rasoul Yousefimashouf
- Department of Microbiology, School of MedicineHamadan University of Medical Sciences Hamadan Iran
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Katkowska M, Garbacz K, Kopala W, Schubert J, Bania J. Genetic diversity and antimicrobial resistance of Staphylococcus aureus from recurrent tonsillitis in children. APMIS 2019; 128:211-219. [PMID: 31692060 DOI: 10.1111/apm.13007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
Abstract
The aim of this study was to analyze the prevalence of Staphylococcus aureus in the tonsils of children subjected tonsillectomy due to recurrent tonsilitis and to determine the spa types of the pathogens, carriage of virulence genes and antimicrobial resistance profiles. The study included 73 tonsillectomized children. Bacteria, including S. aureus were isolated from tonsillar surface prior to tonsillectomy, recovered from tonsillar core at the time of the surgery, and from posterior pharynx 2-4 weeks after the procedure. Staphylococcus aureus isolates were compared by spa typing, tested for antimicrobial susceptibility and for the presence of superantigenic toxin genes (sea-seu, eta, etb, tst, lukS/lukF-PV) by multiplex polymerase chain reaction. Seventy-three patients (mean 7.1 ± 4.1 years, 61.6% male) were assessed. The most commonly isolated bacteria were S. aureus. The largest proportion of staphylococcal isolates originated from tonsillar core (63%), followed by tonsillar surface (45.1%) and posterior pharynx in tonsillectomized children (18.2%, p = 0.007). Five (6.3%) isolates were identified as MRSA (mecA-positive). Up to 67.5% of the isolates synthesized penicillinases (blaZ-positive isolates), and 8.8% displayed MLSB resistance. The superantigenic toxin genes were detected in more than half of examined isolates (56.3%). spa types t091, t084, and t002, and clonal complexes (CCs) CC7, CC45, and CC30 turned out to be most common. Staphylococcus aureus associated with RT in children showed pathogenicity potential and considerable genetic diversity, and no clones were found to be specific for this condition although further studies are needed.
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Affiliation(s)
- Marta Katkowska
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Wacław Kopala
- Voivodeship Specialist Children's Hospital, Olsztyn, Poland
| | - Justyna Schubert
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jacek Bania
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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14
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Abu Bakar M, McKimm J, Haque SZ, Majumder MAA, Haque M. Chronic tonsillitis and biofilms: a brief overview of treatment modalities. J Inflamm Res 2018; 11:329-337. [PMID: 30233227 PMCID: PMC6134941 DOI: 10.2147/jir.s162486] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recurrent tonsillitis is described as when an individual suffers from several attacks of tonsillitis per year. Chronic and recurrent tonsillitis both cause repeated occurrences of inflamed tonsils which have a significant impact on a patient's quality of life. Numerous children suffer from recurrent tonsillitis and sore throats, and these illnesses become part of their life. Antimicrobials can provide temporary relief, but in many cases, tonsillitis recurs. The cause of such recurrent infections have been identified as microorganisms which often create biofilms and a repository of infection in the wet and warm folds of the tonsils. This review discusses different treatment modalities, their advantages and disadvantages, and new treatment options focusing on biofilms. All treatment options should be selected based on evidence and individual need.
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Affiliation(s)
- Muhamad Abu Bakar
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia,
| | - Judy McKimm
- Swansea University School of Medicine, Swansea University, Swansea, wales, UK
| | | | | | - Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia,
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15
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Wittlinger J, Stankovic P, Girrbach U, Gradistanac T, Güldner C, Teymoortash A, Hoch S, Günzel T, Wilhelm T. Hyperplasia and the degree and activity of inflammation in chronic recurrent tonsillitis: a histopathological study. Eur Arch Otorhinolaryngol 2017; 274:2927-2932. [PMID: 28439693 DOI: 10.1007/s00405-017-4575-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/17/2017] [Indexed: 11/28/2022]
Abstract
Postoperative haemorrhage following tonsillectomy occurs in 5.98% of all cases with up to 10 deaths reported annually in Germany. When comparing tonsillectomy (TE) and tonsillotomy (TT), the same long-term frequency of ENT infections is displayed in children and young adults. However, taking postoperative haemorrhaging into account, TT is more favourable. Chronic tonsillitis is one of the most common indications for TE in the adult population; however, a histopathological characterization may reveal objective criteria and provide a foundation for routinely performing TT in adults too. Three essential parameters hyperplasia (HP), grade of inflammation (GOI) and activity of inflammation (AOI), which are responsible for, and associated with a clinically relevant disease were histopathologically examined in the tonsils of 100 adult patients with chronic recurrent tonsillitis. The parameters were analysed and compared separately in the pharyngeal and basal parts of the tonsils as well as in three sections (upper and lower pole of the tonsil, middle part) as this may influence the indication for TT. The comparison of the basal and pharyngeal portions displayed a significant difference in the GOI and the HP in all three sections: grade 2 HP as well as GOI were more commonly found in the basal than pharyngeal portions (p > 0.001). AOI (grade 2) displayed the same properties in the middle section (p < 0.002), but did not reach statistical significance in the cranial and caudal sections (p = 0.107 and p = 0.186). An overabundance of grade 1 GOI, AOI, and HP was seen in the pharyngeal sections. The results show that two out of three relevant parameters that demonstrate histopathological changes in recurrent inflamed tonsils have a significantly stronger presence in the basal section of the tonsil as opposed to the pharyngeal section. The processes initiated by inflammation next to the surface responsible for a clinically relevant recurrent tonsillitis seem to cause stronger reactions in the deep follicular portion of the tonsils.
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Affiliation(s)
- Jan Wittlinger
- Department of Otolaryngology, Head/Neck and Facial Plastic Surgery, Sana Kliniken Leipziger Land, Rudolf-Virchow-Strasse 2, 04552, Borna, Germany
| | - Petar Stankovic
- Department of Otolaryngology, Head/Neck and Facial Plastic Surgery, Sana Kliniken Leipziger Land, Rudolf-Virchow-Strasse 2, 04552, Borna, Germany
| | - Ulrike Girrbach
- Institute of Pathology, University Leipzig, Leipzig, Germany
| | | | - Christian Güldner
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University Marburg, Marburg, Germany
| | - Afshin Teymoortash
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University Marburg, Marburg, Germany
| | - Stephan Hoch
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University Marburg, Marburg, Germany
| | - Thomas Günzel
- Department of Otolaryngology, Head and Neck Surgery, Borromäus Hospital, Leer, Germany
| | - Thomas Wilhelm
- Department of Otolaryngology, Head/Neck and Facial Plastic Surgery, Sana Kliniken Leipziger Land, Rudolf-Virchow-Strasse 2, 04552, Borna, Germany.
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16
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Mamishi S, Moradkhani S, Mahmoudi S, Hosseinpour - Sadeghi R, Pourakbari B. Penicillin-Resistant trend of Streptococcus pneumoniae in Asia: A systematic review. IRANIAN JOURNAL OF MICROBIOLOGY 2014; 6:198-210. [PMID: 25802701 PMCID: PMC4367934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The high prevalence of resistance to penicillin by Streptococcus pneumoniaeis considered as a great concern, particularly in Asian countries. The aim of this study was to investigate the changing trend of penicillin-resistant S. pneumoniae (PRSP) in Asia over a 20 years period. A review of the literature was conducted using the PubMed database, Google Scholar, Scopus, two Persian scientific search engines "Scientific Information Database" (www.sid.ir), and "Mag Iran" (www.magiran.com) through 1993 to 2013. Our study provides a unique chance to investigate the changing trend in PSSP in Asia over a 20 years period. Susceptibility rates among different centers in each country varied widely. In Malaysia, the PSSP rate decreased from 97.2% in 1995-1996 to 69% in 2000. In Singapore, PSSP levels decreased from 72.6% in 1997 to 30.5% in 2007-2008. In Iran, PSSP ranged from 0% to 100%. In Taiwan, the rate of PSSP was 60.3% in 1995 and <50% in other years. In Lebanon, the rate of PSSP was less than 50% (ranging from 30.1% to 50%) in all published data. In Hong Kong, the level of penicillin susceptibility decreased from 71.1% during 1993-1995 to less 42% in 2007. Continuous surveillance of resistance data from clinical isolates as well as implementation of strict infection control policies is recommended. More studies are needed for better evaluation PSSP rate in some Asian countries such as Vietnam, Singapore, Philippines, Pakistan, Nepal, Kuwait, Korea and Indonesia.
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Affiliation(s)
- Setareh Mamishi
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran,Department of Infectious Disease, School of Medicine, TehranUniversity of Medical Sciences, Tehran, Iran
| | - Sepideh Moradkhani
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Babak Pourakbari
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Mailing address: Pediatrics Infectious Diseases Research Center, Children Medical Center Hospital School of Medicine, Tehran University of Medical Sciences, No.62, Gharib St., Keshavarz Blvd., Tehran, Iran. Tel: +98- 21- 6642- 8996, Fax: +98- 21- 6642- 8996,
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