Author(s): Binu Babu1, Anjana Mary Reynolds2
The study was aimed at finding out the bacteriology of the tonsillar surface and core, in those patients undergoing tonsillectomy at a tertiary care hospital. The study was also planned to look for the antibiotic resistance pattern among organisms identified and to see whether a tonsillar surface swab can be used as a surrogate for finding out the aetiopathogenesis of tonsillar infections.
This is a 2-year cross-sectional study of 100 patients undergoing who consented for the study, after taking a smear from the surface of the tonsil. Tonsillectomy was done by dissection and snare method. The core of the tonsil is then biopsied and microbiological culture and sensitivity is done. The bacteria were identified by morphology and staining characteristics and cultured using standard laboratory procedures. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. The data was digitalised using a data entry platform using Epidata and analysed using SPSS 16. Relativity between organism identified as the surface and core was tested using Chi-square tests and Kappa statistics.
There were significant differences between the organisms identified from the tonsillar surface and the core; out of the 200 specimens, only 48 showed a similar bacteriology. The viability between the surface and the core specimens were measured using Kappa statistics and was found to be 0.04, which shows a very poor agreement between them.
Assessment of antibiotic sensitivity shows that Staph aureus was resistant to most of the commonly used antibiotics. H. influenza isolated showed 70% susceptibility to erythromycin and cotrimoxazole. While group A β haemolytic streptococci showed 95% susceptibility to ampicillin and 100% to erythromycin.
Staph. aureus, H. influenza, Streptococci pneumonia were the major pathogenesis identified from the tonsil of the patients undergoing tonsillectomy, and bacteriology was different between the tonsillar surface and the core. Also the staphylococcal showed high level of resistance towards first line antibiotics.