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Correlation Between Microbiological Profiles of Adenoid Tissue and Nasal Discharge in Children with Co-Existent Chronic Adenoiditis and Chronic Rhinosinusitis

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Correlation Between Microbiological Profiles of Adenoid Tissue and Nasal Discharge in Children with Co-Existent Chronic Adenoiditis and Chronic Rhinosinusitis Published online: 2019-04-23 Correlation between microbiological profiles of adenoid tissue and nasal discharge in children with co-existent chronic adenoiditis and chronic rhinosinusitis. Dr Rohit Singh, Associate Professor ENT-HNS,Kasturba Medical College,Manipal,Manipal Academy of Higher education India Introduction: After incubation the plates were observed up to 7 days for Chronic adenoiditis leading to adenoid hypertrophy is common in presence. of growth. Gram staining was done from each colony children. Many of those affected children would also have co- prototypes and identification was done by bio-chemical existing chronic rhinosinusitis(CRS). Infact, long lasting bacterial reaction. For Anaerobic culture of the adenoid tissue infection of the adenoids has been hypothesized to be the one of specimen, the inoculated specimen in Robertson’s cooked meat broth bottles were incubated for 48 hours and then the causes for CRS in these children. There are reports of were cultured on Blood agar, Neomycin blood agar & Phenyl Discussion: Our results do not support the bacteriological improved signs and symptoms of CRS after the removal of the ethyl alcohol, and then the plates were incubated association between the adenoiditis and CRS. Kim et al(2018) hypertrophied adenoids in the same children. Though, bacteria anaerobically in anaerobic work station . Both the nasal swab study on 12,000 children followed up for up to 9 years, isolated from the adenoids have been implicated in the and the tissue were inoculated onto Sabouraud’s dextrose agar for fungal culture. The period of incubation in culture downplayed the beneficial effect of adenoidectomy on sinusitis. pathogenesis of CRS, not many authors have studied the conditions varied ranging from 48 hours to 3 weeks. However, An den Aardweg et al (2010) Cochrane review itself has bacteriological profiles of both the CRS and the adenoiditis for the growth to be considered as negative for any organism, concluded that the evidence regarding the beneficial effect of together. the minimum incubation period considered was 48 hours in adenoidectomy on CRS symptoms to be insufficient and Objectives: case of aerobic culture, 5 days for anaerobic culture and 5 days for fungal culture. The organism cultured from these inconclusive. Even if there is any symptomatic benefit in CRS • To study the association between the microbiological profiles specimens were tabulated, and the correlation between the children after adenoidectomy, it is unlikely to be due to the of the adenoiditis and the CRS in children diagnosed to have nasal specimens and the adenoid tissue specimens was removal of reservoir of pathogenic bacteria. This symptomatic analyzed. Results: these co-existing conditions. relief could be attributed to the relief of mechanical obstruction Nasal swab Adenoid tissue • The purpose is to identify the etio-pathological similarities Age otherwise caused by hypertrophied adenoids and to the in Aerobic Fungal Aerobic Anaerobic Fungal between these conditions, if any. Sl no years Sex culture culture culture culture culture improved mucociliary characteristics. Adenoidectomy has been 1 16 M Normal flora No growth No growth PS No growth Materials and Methods: 2 5 F CNS No growth No growth FS No growth shown to improve the nasal mucociliary clearance time and the A cross sectional study was conducted at KMC,Manipal 3 6 M No growth No growth No growth VP No growth 4 10 M CNS No growth No growth VP No growth mucociliary clearance velocity along with subjective relief of India, between September 2016 and February 2017 . The Aspergillus criteria for inclusion into the study was co-existing chronic 5 6 M No growth flavus No growth FS No growth nasal obstruction. 6 13 F No growth No growth Normal flora FS, VP No growth rhinosinusitis in children who were undergoing 7 9 M No growth No growth No growth VP No growth Our results were similar to Elwany et al (2011) study in terms of adenoidectomy for chronic adenoiditis. After parents 8 4 M Normal flora No growth Normal flora FS, PS No growth 9 15 M No growth No growth Normal flora VP No growth anaerobic bacterial isolation from adenoid core tissue. consents, the nasal swabs were taken from the study 10 4 F No growth No growth Normal flora FS No growth participants under general anesthesia, during the MSSA 11 7 M (Scanty) Bipolaris No growth VP No growth Conclusions : adenoidectomy procedure. The nasal swabs were collected 12 5 M No growth No growth Normal flora FS No growth from middle meatus under endoscopic guidance just before 13 5 M MRSA (Heavy) No growth No growth FS No growth The is no significant bacteriological association between adenoiditis the adenoid resection by cold instruments. The nasal 14 9 F No growth No growth No growth FS No growth 15 13 M No growth No growth No growth FS No growth and chronic rhinosinusitis in pediatric age groups. Adenoidectomy swabs and then the curetted adenoid tissue were collected 16 12 F MRSA (Heavy) No growth MRSA (Moderate) No (5) No growth 17 5 M No growth No growth No growth FS No growth into a sterile container and sent for bacterial as well as 18 3 F No growth No growth BHS. FS No growth relieves mechanical obstruction and not necessarily the reservoir of fungal culture and sensitivity studies. For anaerobic culture, MSSA adenoid tissues were inoculated directly into Robertson’s 19 13 M (Moderate) No growth No growth FS No growth pathogenic bacteria. Though we were not able to establish any MSSA cooked meat broth. The nasal swabs were directly 20 5 F (Scanty) No growth Normal flora FS, VP. No growth bacteriological association with the CRS in our cohorts, the inoculated onto 5% sheep blood agar and chocolate agar for aerobic bacterial growth, whereas adenoid tissue significant growth of the anaerobes from the core of the inflamed specimen was grounded and inoculated onto 5 % sheep adenoids has prompted us to suggest the inclusion of the antibiotics blood agar and Mac-Conkey agar and then incubated at Table 1: The culture reports of the study cohort. Sl no- serial number of patient, M – male, F – female, CNS - Coagulase negative Staphylococcus sp, MSSA - Methicillin Sensitive Staphylococcus aureus, MRSA - Methicillin against the anaerobes in the medical management of these children, 35-37°C. Resistant Staphylococcus aureus, BHS - Beta haemolytic streptococcus sp, FS - Fusobacterium sp, VP - . Copyright © 2019 Dr.Rohit Singh, Email : Veilonella parvula, PS - Prevotella sp. The age is in years and the numbers in paracentesis denote days of [email protected] incubation in culture conditions. whenever feasible. .
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