Microbiological Analysis of Punch Biopsies of Tonsillar Crypts of Patients with Chronic Tonsillitis

Abstract

Statement of the Problem: Medicine identified that recurrent and chronic infections of palatine tonsils are exacerbated by the creation of biofilms by microorganisms in the wet and warm folds of the tonsils which act as a repository of infection (Abu Bakar et al., 2018). Although 99% of all bacteria exist within biofilms, it is the planktonic state and swab samples from tonsillar surface that historically have received the attention. This is likely due to the fact that disease - causing bacteria is grown more rapidly in the planktonic form and it is much easier to sample fluids as opposed to surfaces (Snyder et al., 2009). Clinical Practice: At Pauls Stradiņs Clinical University Hospital was decided to microbiologically analyze the punch biopsy samples of tonsillar crypts of patients with chronic tonsillitis. Patients who met Paradise criteria were admitted to the Department of Otorhinolaryngology for tonsillectomies. Biopsies were taken before operations. Pathogenic bacteria of biopsy samples were tested for antibacterial susceptibility and biofilm producing ability. Results of the microbiological analysis revealed variety of pathogenic bacteria with resistance to common antibiotics un strong biofilm formation ability. Conclusion & Significance: Isolated pathogens from tonsillar crypts were resistant to antibiotics which are used to treat tonsillitis. Isolated pathogens from tonsillar crypts were weak, moderate or strong biofilm producers. Only 20 % of strains did not produce biofilm. During further studies the role of strong biofilm producers has to be evaluated as biofilm production plays a key role in the pathogenesis of chronic tonsillitis.