Condition of nasopharynx contamination in children with chronic tonsillitis and gastroesophageal reflux disease

Abstract

The aim was to study the condition of nasopharynx contamination in children with chronic tonsillitis depending on the presence of pathological gastro-esophageal reflux.Materials and methods. In total, 44 children aged 4.60 ± 0.14 years were enrolled in the study. The index group comprised 22 people with chronic tonsillitis and gastroesophageal reflux disease (GERD); the control group consisted of 22 people with chronic tonsillitis but without GERD. Samples of nasopharynx secretion (pharyngeal and nasal swabs) were taken for culture and their results were analyzed. The results were statistically processed with the use of Microsoft Office Excel and Statistica 13 software.Results. It was found that pharyngeal cultures obtained from children of the index group tended to reveal H. influenzae in the swab more frequently (in 77.3 %, P = 0.06). This microorganism was revealed in nasal cultures of children with GERD (in 31.8 %, P = 0.02) and only in mixed and acid reflux (30.0 % and 80.0 %, respectively). 63.6 % of children from the index group were culture positive for more than two microorganisms, which was typical for half of the children with mixed and acid reflux (13.6 %, P = 0.002). It was defined that children with GERD and colonized by H. influenzae, demonstrated higher rates of total quantity of acid reflux (193.86 ± 40.46 compared to 104.80 ± 2.06, P = 0.05), persistent acid reflux (7.50 ± 1.62 compared to 3.67 ± 1.20, P = 0.04), as well as percentage of acid reflux per day (26.17 ± 7.23 compared to 7.44 ± 2.06, P = 0.004).Conclusions. Contamination of pharyngeal and nasal mucous membranes in children with GERD and chronic tonsillitis was represented by potentially pathogenic bacterial microflora (in 95.5 %) with the prevalence of H. influenzae. More than two microorganisms were revealed in children with mixed and acid reflux (P = 0.05). Children with GERD and chronic tonsillitis, provided H. influenzae colonization, demonstrated higher rates of total quantity of acid reflux (P = 0.05), persistent acid reflux (P = 0.04), as well as percentage of acid reflux per day (P = 0.004).