Charakterystyka flory bakteryjnej i biofilmu na powierzchni migdałka gardłowego u dzieci z przewlekłym zapaleniem migdałka gardłowego

Abstract

Planctonic and biofilms infections of adenoid play important role in clinical course of chronic adenoiditis in children. The aim of the study was estimation of the biofilms and pathogenic flora on the human adenoid surface in children with chronic adenoiditis. Investigations performing in 2008-2009 in ENT Department of Children's Hospital in Warsaw obtained 10 children qualified to adenoidectomy (9 boys and 1 girl in age from 3 to 10 years, middle age 4.7 years). Group I contained 6 children with hypertrophy of adenoid. Group II contained 4 children with chronic adenoiditis and otitis media with effusion. Adenoidectomy was performed in all patients. Adenoid was divided on three parts. Adenoid surface swab were taken on bacteriological and fungoid culture from one portion of adenoid. Second part of adenoid was prepared for Scanning Electron Microscopy (SEM) and the last one to pathomorfology investigation. The control nasopharynx swabs were taken four weeks after adenoidectomy. Bacterial biofilms were found in all adenoids in SEM and funguses were presented in 80%. Bacterial biofilms cover bigger part of adenoid surface in patients after three and more antibiotic treatments than in patients after two or less antibiotic treatments. In all patients histopathological examination confirmed suppurative chronic adenoiditis. Adenoid is covered by bacterial biofilms and fungi. Adenoidectomy restores physiological flora in nasopharynx in children with hypertrophy of adenoid. Biofilms cover whole adenoid's surface in children after repeated antibiotic treatment.