Adenoid Samples Research Articles

A cross-tissue, age-specific flow cytometry reference for immune cells in the airways and blood of children

Respiratory diseases are a common cause of morbidity and hospitalization for children. Despite this, treatment options are limited and are often ineffective. The development of curative or disease-modifying treatments for children relies on a better understanding of underlying immunity in the early airway. To establish a flow cytometry dataset for immune cells in the pediatric airway, we analyzed 180 samples from 68 children aged between 1 and 15 years. This included 5 tissues of the upper (nasal brushings, palatine tonsils, adenotonsil) and lower (bronchial brushings, bronchoalveolar lavage) airway, as well as whole blood for paired analysis of local and systemic immune response. Nasal, bronchial, and alveolar samples were analyzed using a 17-plex antibody panel that captures cells of immune and epithelial lineage, while tonsil, adenoid, and blood samples were analyzed using a 31-plex antibody panel that extensively phenotypes mononuclear immune cells. All protocols, panels, and data are openly available to facilitate implementation in pediatric clinical laboratories. We provide age-specific airway cell data for infancy (0-2 years), preschool (3-5 years), childhood (6-10 years) and adolescence (11-15 years) for 37 cell populations. We show tissue-specific maturation of the airway immune system across childhood, further highlighting the importance of developing age-specific references of the pediatric airway. Intraindividual, cross-tissue analysis of paired samples revealed marked correlation in immune cell proportions between paired nasal-bronchial samples, paired tonsil-adenoid samples, and paired adenoid-blood samples, which may have implications for clinical testing. Our study advances knowledge of airway immunity from infancy through to adolescence and provides an openly available control dataset to aid in interpretation of clinical findings in samples obtained from children with respiratory diseases.

Microbiome of the Middle Meatus, Tonsils, and Adenoids in Pediatric Chronic Rhinosinusitis.

Pediatric chronic rhinosinusitis (PCRS) is a common condition with a significant impact on quality of life. This study compares the microbiome of pediatric patients with and without chronic rhinosinusitis. Single-center, prospective, quantitative case-control. Metropolitan. Patients undergoing adenoidectomy for PCRS (subjects, n = 20) or obstructive sleep apnea (controls, n = 20) were recruited. 16S ribosomal RNA sequencing was performed on the right middle meatus (MM), adenoid, and palatine tonsil samples from each patient. Alpha diversity was measured by the Simpson's diversity index, beta diversity was measured by the Bray-Curtis dissimilarity index, and the differential abundance of bacteria genera was analyzed. There were 40 adenoid, 40 tonsil, and 37 MM samples analyzed. There was no significant difference in alpha diversity between controls and subjects. Tonsils were significantly more diverse than the adenoids, which were more diverse than the MM (P < .001). There was no difference in bacterial composition between controls and subjects, but the composition of the 3 sites were significantly different (P < .001). The dissimilarity in bacterial composition between the adenoid and MM sites was larger in the control group than in the subject group. There were significant differences in alpha diversity and bacterial composition between the anatomic 3 sites; however, there was no difference between the controls and subjects. The larger dissimilarity in bacterial composition between adenoid and MM sites in controls compared to subjects suggests there may be colonization of the MM by the adenoid in PCRS patients.

The role of adenoid immune phenotype in polysensitized children with allergic rhinitis and adenoid hypertrophy.

There is increasing interest in elucidating the relationship between adenoid hypertrophy (AH) and allergic rhinitis (AR). However, the impact of aeroallergen sensitization patterns on children with AH and AR remains unclear. Patients aged 2-8 years (recruited from January 2019 to December 2022) with nasal symptoms were assessed for allergies, adenoid size, and respiratory viral infection history. The serum total immunoglobulin E (IgE) and specific IgE levels were measured, and flexible nasal endoscopy was performed. The relationship between AH, aeroallergen sensitization patterns, and lymphocyte subpopulations in adenoid samples was analyzed using flow cytometry. In total, 5281 children were enrolled (56.5% with AR; and 48.6% with AH). AH was more prevalent in children with AR. Compared to nonsensitized individuals, those polysensitized to molds had a higher prevalence of AH (adjusted OR 1.61, 95% CI 1.32-1.96) and a greater occurrence of two or more respiratory viral infections, particularly in adenoidectomy patients. The percentages and corrected absolute counts of regulatory T (Treg) cells, activated Tregs, class-switched memory B cells (CSMBs), natural killer (NK) T cells, and NK cell subpopulations were reduced in the adenoid tissues of children with both AH and AR (AH-AR) compared to AH-nAR children. Polysensitization in AH-AR children correlated with lower CSMB percentages. Polysensitivity to molds is associated with an increased risk of AH in children with AR. Fewer B cells, NK cells, and Treg cells with an effector/memory phenotype were detected in the adenoids of AR children, and these lower percentages of immune cells, particularly CSMBs, were closely linked to aeroallergen sensitization models and respiratory viral infection.

Nasal and Pharyngeal Mucosal Immunity to Poliovirus in Children Following Routine Immunization With Inactivated Polio Vaccine in the United States.

Although polioviruses (PVs) replicate in lymphoid tissue of both the pharynx and ileum, research on polio vaccine-induced mucosal immunity has predominantly focused on intestinal neutralizing and binding antibody levels measured in stool. To investigate the extent to which routine immunization with intramuscularly injected inactivated polio vaccine (IPV) may induce nasal and pharyngeal mucosal immunity, we measured PV type-specific neutralization and immunoglobulin (Ig) G, IgA, and IgM levels in nasal secretions, adenoid cell supernatants, and sera collected from 12 children, aged 2-5 years, undergoing planned adenoidectomies. All participants were routinely immunized with IPV and had no known contact with live PVs. PV-specific mucosal neutralization was detected in nasal and adenoid samples, mostly from children who had previously received 4 IPV doses. Across the 3 PV serotypes, both nasal (Spearman ρ ≥ 0.87, P ≤ .0003 for all) and adenoid (Spearman ρ ≥ 0.57, P ≤ .05 for all) neutralization titers correlated with serum neutralization titers. In this small study sample, there was insufficient evidence to determine which Ig isotype(s) was correlated with neutralization. Our findings provide policy-relevant evidence that routine immunization with IPV may induce nasal and pharyngeal mucosal immunity. The observed correlations of nasal and pharyngeal mucosal neutralization with serum neutralization contrast with previous observations of distinct intestinal and serum responses to PV vaccines. Further research is warranted to determine which antibody isotype(s) correlate with polio vaccine-induced nasal and pharyngeal mucosal neutralizing activity and to understand the differences from intestinal mucosal immunity.

Correlation Between Nasal Allergy and the Number of Eosinophils in Adenoid Tissue.

To study adenoid tissue eosinophilia in allergic rhinitis. A single-centre clinical case-control prospective study with 66 subjects enrolled for the study after taking written informed consent from all the participants. All patients underwent adenoidectomy with histopathological evaluation of adenoid tissue samples for eosinophils. 36 patients (cases) with Symptoms for Allergic Rhinitis (SFAR) score indicative of allergic rhinitis. 30 patients (control) with SFAR scores not indicative of allergic rhinitis. All patients were evaluated for serum absolute eosinophil count and total serum immunoglobulin E (Ig-E). There was a significant relationship between allergic rhinitis and serum Ig-E levels using the Kruskal-Wallis rank sum test amongst case and control groups with a p-value of 0.031. Pathologically examined slides of adenoid tissue eosinophil count per 10 random high power fields in these patients showed significant results with a p-value of 0.002432, via the Kruskal-Wallis rank sum test. Statistical analysis, shows that adenoid tissue eosinophil count and serum Ig-E levels can somewhat predict the presence of clinical features of allergic rhinitis. Based on several similar studies with similar results, allergic rhinitis can be gauged with adenoid tissue histopathology and routine evaluation should be considered as a standard of care.

Bacteriology of Adenoids and Tonsils in Children With Recurrent Adenotonsillitis.

Recurrent adenotonsillitis (AT) commonly affects children and may be associated with various complications. Infections are common etiology, and microbial profiles may vary widely in different cases. In this study, we evaluated the bacterial profile and antibiotic sensitivity of pathogens identified in tonsil and adenoid core cultures in children with recurrent AT. In this cross-sectional, observational study, culture and antibiotic sensitivity were performed from tonsil and adenoid core samples obtained after adenotonsillectomy of children (5 to 18 years) with recurrent AT. Children who had received antibiotics within one week before surgery were excluded. Drug sensitivity was performed only for drugs available on the hospital panel list. Bacterial growth was observed in 83 (91.2%) tonsil core cultures (n=91) and 43 (79.6%) adenoid core cultures (n=54). In the tonsil and adenoid core cultures, poly-microbial growth was seen in 25 (27.0%) and 11 (25.6%) children, respectively. From the tonsil core cultures, the majority of the bacteria were sensitive to ciprofloxacin, ampicillin, piperacillin-tazobactam, cefoperazone-sulbactam, ceftazidime, cefotaxime, levofloxacin. From the adenoid core culture, the majority of the bacteria were sensitive to ciprofloxacin, ampicillin, piperacillin-tazobactam, cefoperazone-sulbactam, cephalexin, and cefotaxime. In recurrent AT, polymicrobial growth is not uncommon in both tonsil and adenoid core cultures. Identifying the correct pathogens and their antibiotic sensitivity patterns can help plan treatment strategies for the effective management of recurrent AT.

Possible Role of Helicobacter pylori in Ear Nose and Throat Diseases.

Helicobacter pylori is assumed to cause many gastric and extragastric diseases. We aimed to assess the possible association role of H. pylori in Otitis media with effusion (OME), nasal polyps and adenotonsillitis. A total of 186 patients with various ear, nose and throat diseases were included. The study comprised 78 children with chronic adenotonsillitis, 43 children with nasal polyps and 65 children with OME. OME patients were assigned to two subgroups: those who have and those who did not have adenoid hyperplasia. Among the patients with bilateral nasal polyps, 20individuals had recurrent nasal polyps and 23 had de novo nasal polyps. Patients who have chronic adenotonsillitis were divided into three groups: those with chronic tonsillitis and those who underwent tonsillitis, those with chronic adenoiditis and adenoidectomy was performed, and those with chronic adenotonsillitis and underwent adenotonsillectomy. In addition to examination of H. pylori antigen in stool samples of all included patients, real-time polymerase chain reaction (RT-PCR) for detection of H. pylori in the effusion fluid was performed, additionally, Giemsa stain was used for detection of H. pylori organism within the tissue samples when available. Frequency of H. pylori in effusion fluid was 28.6% in patients with OME and adenoid hyperplasia, while in those with OME it was only 17.4% with a p value of 0.2. Nasal polyp biopsies were positive in 13% patients of denovo, and 30% patients with recurrent nasal polyps, p=0.2. De novo nasal polyps were more prevalent in the positive stools than recurrent ones, p=0.7. All adenoid samples were negative for H. pylori, only two samples of tonsillar tissue (8.3%) were positive for H. pylori, and stool analysis was positive in 23 patients with chronic adenotonsillitis. Lack of association between Helicobacter pylori and occurrence of OME, nasal polyposis or recurrent adenotonsillitis.

Analysis of Tonsil Tissues from Patients Diagnosed with Chronic Tonsillitis-Microbiological Profile, Biofilm-Forming Capacity and Histology.

Chronic tonsillitis (CT) is a global health issue which can impair patient's quality of life and has an important socioeconomic impact due to the nonrational use of antibiotics, increased antimicrobial resistance and frequent need for surgical treatment. In order to isolate and identify the causing agents of CT, a total of 79 postoperative palatine and adenoid tissue samples were obtained from the ENT Clinic, KBC Zvezdara, Belgrade, Serbia. Culture identification was performed by MALDI-TOF MS and the Staphylococcus aureus isolates were tested for biofilm forming capability and antibiotic susceptibility. Additionally, a histological examination of palatine and adenoid tissue was performed in order to detect the presence of CT-causing bacteria. The slight majority of participants were females with median age of 28 years for adult patients (group I) and 6 years for children (group II). Analysis of the incidence of bacteria isolated from tissue samples in both groups showed the highest prevalence of S. aureus, Streptococcus oralis and Streptococcus parasanquinis. In addition to interfollicular hyperplasia, colonies of species S. aureus were detected in histological material. The presence of biofilm might be the reason for the recurrence of infection. Therefore, searching for a new treatment of CT is of great importance.

An Overview of Adenoid Microbiome Using 16S rRNA Gene Sequencing-Based Metagenomic Analysis.

Background and Objectives: the upper respiratory tract harbors the highest bacterial density in the whole respiratory system. Adenoids, which are located in the nasopharynx, are a major site of bacterial colonies in the upper airways. Our goal was to use culture-independent molecular techniques to identify the breadth of bacterial diversity in the adenoid vegetations of children suffering from chronic rhinosinusitis and obstructive sleep apnea. Materials and methods: in total, 21 adenoid samples were investigated using amplification and sequencing of the V3-V4 hypervariable region of the bacterial 16S rRNA gene. Results: among the most common bacterial species found were Veillonella atypica, Fusobactrium nucelatum, Shaalia odontolytica, and Moraxella catarrhalis. Veillonella atypica and Fusbacterium nucelatum dominated the microbiome in all 21 samples, attributing to more than 60% of all detected genetic material. Conclusions: since both Veillonella atypica and Fusobacterium nucleatum are, predominantly, oral cavity and dental microorganisms, our findings may suggest oral microbiome migration deeper into the oropharynx and nasopharynx where these bacteria colonize adenoid vegetations.

Predominant Bacterial and Viral Otopathogens Identified Within the Respiratory Tract and Middle Ear of Urban Australian Children Experiencing Otitis Media Are Diversely Distributed.

BackgroundOtitis media (OM) is one of the most common infections in young children, arising from bacterial and/or viral infection of the middle ear. Globally, Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the predominant bacterial otopathogens. Importantly, common upper respiratory viruses are increasingly recognized contributors to the polymicrobial pathogenesis of OM. This study aimed to identify predominant bacteria and viruses in the nasopharynx, adenoids and middle ears of peri-urban/urban South-East Queensland Australian children, with and without clinical history of chronic otitis media with effusion (COME) and/or recurrent acute otitis media (RAOM).MethodsSixty children, 43 diagnosed with OM and 17 controls with no clinical history of OM from peri-urban/urban South-East Queensland community were recruited to the study. Respiratory tract bacterial and viral presence were examined within nasopharyngeal swabs (NPS), middle ear effusions (MEE) and adenoids, using real-time polymerase chain reaction (RT-PCR) and bacterial culture.ResultsAt least one otopathogen present was observed in all adenoid samples, 86.1% and 82.4% of NPS for children with and without OM, respectively, and 47.1% of the MEE from the children with OM. NTHi was the most commonly detected bacteria in both the OM and control cohorts within the adenoids (90.0% vs 93.8%), nasopharynx (67.4% vs 58.8%) respectively, and in the MEE (OM cohort 25.9%). Viruses were detected in all adenoid samples, 67.4% vs 47.1% of the NPS from the OM and control cohorts, respectively, and 37% of the MEE. Rhinovirus was the predominant virus identified in the adenoids (85.0% vs 68.8%) and nasopharynx (37.2% vs 41.2%) from the OM and control cohorts, respectively, and the MEE (19.8%).ConclusionsNTHi and rhinovirus are predominant otopathogens within the upper respiratory tract of children with and without OM from peri-urban and urban South-East Queensland, Australia. The presence of bacterial otopathogens within the middle ear is more predictive of concurrent URT infection than was observed for viruses, and the high otopathogen carriage within adenoid tissues confirms the complex polymicrobial environment in children, regardless of OM history.

Mycobiome in the Middle Ear Cavity with and Without Otitis Media with Effusion.

Objective:No data have yet been published revealing the composition and the diversity of fungal communities (mycobiome) in the human middle ear cavity. The presented study investigated the mycobiome in the middle ear cavities of individuals with healthy middle ears and patients with otitis media with effusion.Methods:A total of 77 middle ear and four adenoid samples were collected from 47 individuals (35 children and 12 adults) in Group 1 and from 20 children in Group 2. The mycobiome profile was analyzed with nuclear ribosomal internal transcribed spacer 2 (ITS2) based metabarcoding using an Illumina MiSeq metagenomics kit.Results:ITS2-based metabarcoding detected 14 different genera and 17 different species with a mean relative abundance of ≥1% in the samples analyzed. Mycobiome profile was similar between the adenoid tissue and the middle ear cavity, between Groups 1 and Group 2, and between children and adults. Fusarium, Stemphylium, Candida, and Cladosporium were the most abundant genera detected in all samples. The mean relative abundances of the genera Candida and Fusarium were remarkably higher in Group 2 compared to Group 1.Conclusion:The species Candida glaebosa, Candida cretensis, Aspergillus ruber, Penicillium desertorum, and Rhizopus arrhizus were significantly more abundant in patients with otitis media with effusion (OME), raising the possibility that they affect the pathogenesis of OME.

Preoperative SARS-CoV-2 Screening Fails to Detect Viral Particles Prior to Airway Surgery.

Objectives/HypothesisChildren have higher rates of asymptomatic SARS‐CoV‐2 infections or milder courses of infection, and their carrier status may potentially impact viral transmission to those providing them care. The aim of this study is to compare the existing COVID‐19 preoperative screening protocols to the detection of SARS‐CoV‐2 viral particles in surgical samples.Study DesignCross‐sectional study.MethodsWe conducted a prospective study with consecutive convenience sampling of children undergoing adenoidectomy between January and April 2021. Total nucleic acid was extracted from adenoid tissue and real‐time reverse transcription‐polymerase chain reaction was conducted to test for the presence of SARS‐CoV‐2 viral particles. Univariate logistic regression was used to summarize the effect size of variables of interest on the odds of having SARS‐CoV‐2 positive adenoid tissue.ResultsForty adenoid samples were collected and 11 (27.5%) had a positive SARS‐CoV‐2 reverse transcriptase‐polymerase chain reaction. Patients with positive adenoids were older (11.8 vs. 7.9 years, odds ratio: 1.3, P = .01) and more likely to have had a positive nasopharyngeal swab in the previous 90 days (4/11 or 36% vs. 0).ConclusionThese data are the first report on the presence of SARS‐CoV‐2 particles in pediatric adenoidectomy specimens, with a high percentage of patients showing evidence of viral particles within the adenoid. This finding calls in to question the utility of preoperative COVID screening protocols which have yet to be rigorously validated in asymptomatic patients and have the potential to delay patients' surgical care.Level of Evidence3 Laryngoscope, 2021

Biofilm formation and molecular analysis of intercellular adhesion gene cluster (icaABCD) among Staphylococcus aureus strains isolated from children with adenoiditis.

Background and Objectives:It is well known that Staphylococcus aureus biofilm plays an important role in adenoiditis and biofilm resistance frequently results in failure of therapy. The goal of this study was to evaluate the biofilm production of S. aureus isolates obtained from adenoid specimens and assess the relationship between biofilm formation ability and ica operon genes.Materials and Methods:A total of 112 adenoid samples were obtained from patients under 15 years old with adenoid hypertrophy. All S. aureus isolates were initially identified by standard microbiological tests and amplification of nuc by polymerase chain reaction (PCR) technique. Biofilm formation of S. aureus isolates was evaluated and icaADBC genes were detected by PCR technique.Results:There were 46 isolates (41%) identified as S. aureus. The ability to produce biofilm was detected among total S. aureus isolates. Molecular study of ica operon revealed that 2 (6.3%) and 19 (59.4%) isolates carried icaA and icaD, respectively. The prevalence of icaA + icaD was seen among 11 (34.4%) S. aureus isolates, while icaC and icaB were not detected.Conclusion:Our findings indicated that icaABCD operon are associated with biofilm formation in S. aureus isolates, however the absence of these genes may not necessarily exclude this property.

The Impact of Adenoid Hypertrophy on Pediatric Chronic Maxillary Sinusitis

Background:The hypertrophied adenoids lay a role in rhinosinusitis, which is not fully unknown. The present view proposed that the hypertrophied adenoids perform as a bacterial pool and restricts the nasal mucociliary clearance. Obstructive adenoids may lead to stasis of nasal secretions with subsequent infection. Aim of the Work:The current work aimed to assess the impact of adenoid enlargement on pediatric chronic maxillary sinusitis [PCMS]. Patients and Methods:This study included 60 Children. The size of adenoid was graded through endoscopic examination. The Clemens grading system was used. Paranasal sinuses were radiologically investigated by computerized axial tomography scan. The radiological and endoscopic data were correlated. Additionally, all adenoid samples were cultivated for bacteriological growth. Result:The highest incidence of adenoid hypertrophy was seen in the age group 3-6 years old [60%], with similar male to female affection rate [1:1]. The positive computed tomography [CT] scan findings among children with hypertrophied adenoid were [55%]. The highest incidence of positive CT findings was found in grade-III adenoids, which is the highest grade of size [33.3%]. Adenoidectomy was performed for all patients and specimens were examined for bacteriological growth. 20% of adenoid tissue had multiple growth and 80.0% showed single organism. The frequency of isolated organism were H. Influenzae, S. Pneumoniae, S. Pyogenes, S. Aureus and Methicillin Resistant Staphylococcus Aureus. Conclusion: The endoscopically graded adenoid hypertrophy is significantly correlated to positive CT scan signs of rhinosinusitis in children. Isolation of bacteria from adenoid tissue supports the inflammatory mechanism of adenoid in pathogenesis of rhinosinutis in addition to its obstructive action. Early initiation of empirical antibiotic therapy is crucial and adenoidectomy provides a cure for adenoid hypertrophy and rhinosinusitis.

Association Between Helicobacter pylori Infection and Otitis Media With Effusion Risk in Children: A Systematic Review and Meta-analysis.

To investigate the potential correlation between Helicobacter pylori infection and otitis media with effusion (OME) risk in children. Electronic databases were searched, including Cochrane Library, PubMed, Embase, China Biology Medicine disc, China Science and Technology Journal Database, Wanfang Database, and China National Knowledge Infrastructure Database. A systematic review and meta-analysis were conducted with Revman 5.3 software. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate infection-disease association. In total, 11 studies from 9 articles regarding H pylori infection and OME risk were enrolled in this meta-analysis. A significant association between H pylori infection and OME was detected for both adenoid samples from the case group (OR, 2.75; 95% CI, 1.43-5.30; P = .002) and middle ear fluid samples from the case group (OR, 4.45; 95% CI, 2.52-7.88; P < .00001). Subgroup analyses suggested a stronger correlation in African and Asian populations. This study indicated the correlation between H pylori infection and increased risk of OME in children, especially in African and Asian populations. Further well-designed studies regarding the white population are strongly recommended in the future.

The microbiomes of adenoid and middle ear in children with otitis media with effusion and hypertrophy from a tertiary hospital in China

IntroductionOtitis media with effusion (OME) is one of the most common pediatric diseases worldwide. Several studies have analyzed the diversity of the microbiomes found in the middle ear effusions (MEEs) of populations from developed countries. However, no microbiological studies of MEEs from Chinese children with OME have been reported. This study investigated the middle ear and adenoid microbiological profiles of children with OME, and compared the microbial flora of the adenoid between children with and without otitis media. MethodsMEEs and adenoid swabs were acquired from 15 children undergoing ventilation tube insertion and adenoidectomy. Adenoid swabs from 15 patients with no ear disease were used as controls. Samples were analyzed by 16S rRNA sequencing. Operational taxonomic units (OTUs) abundance information were normalized. Alpha diversity analyses were used to assess the richness and diversity of the microbial community for each sample. Beta diversity analyses were used to determine the inter-group variability between microbiome structure. ResultsBased on the mean relative abundance, the MEEs were dominated by Haemophilus (14.75%), Staphylococcus (9.37%) and Halomonas (7.85%), and the bacterial compositions of the adenoids in the OME groups were dominated by Haemophilus (21.87%), Streptococcus (19.65%), and Neisseria (5.8%). The bacterial compositions in the adenoids of the controls were dominated by Haemophilus (15.96%), Streptococcus (13.33%), and Moraxella (12.28%).Alpha diversity analyses showed that there were no significant differences in microbiome richness or diversity between the middle ear effusions (TM) and adenoids (TA) of OME subjects. Adenoid samples from OME patients (TA) and control patients (CA) were also similar. Beta diversity analyses showed that the microbiomes of the adenoids in OME patients were also similar to that of controls. However, the microbiome structure of middle ear effusions was dissimilar to those of the adenoids in OME patients according to beta diversity analyses. ConclusionsOur results confirmed the microbial diversity of MEEs among Chinese children. However, the dissimilar microbiome composition between samples taken from the surface of the adenoids and from the middle ear effusions challenges the conventional theory that the adenoid serves as a microbial reservoir in children with otitis media with effusion.

Detection of meningococcus, pneumococcus, Haemophilus influenzae, and group A streptococcus DNA in pediatric adenoid bioptats

Meningococcal, pneumococcal, streptococcal A and Haemophilus influenzae infections are manifested in different clinical forms, ranging from bacterial carriage to generalized life-threatening conditions. However, a connection between bacterial carriage and disease development has not been fully explored. A PCR assay was performed with adenoid biopsy samples collected from 112 children after planned adenotomy to detect Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus pyogenes, H. influenzae carriage. A DNA specific to at least one of the four studied microbial species was found in 104 samples (92.86%) so that: meningococcal DNA was detected in one sample (0.9%), pneumococcal — in 98 (87.5%), H. influenzae — in 19 (16.96%), and streptococcal A — in 42 (37.5%) samples. However, none of these species was found in 8 children (7.14%). A sole S. pneumoniae was detected in 54 samples (48.2%), whereas S. pyogenes — in 5 samples (4.5%). Moreover, two bacterial species were simultaneously as follows: N. meningitidis and S. pneumoniae — in 1 sample (0.9%), S. pneumoniae and H. influenzae — in 7 samples (6.3%); H. influenzae and S. pyogenes — in 1 sample (0.9%); S. pneumoniae and S. pyogenes — in 25 samples (22.3%). A triple combination consisting of S. pneumoniae, H. influenzae and S. pyogenes bacteria were detected together in 11 patients (9.8%). Meningococcal serogrouping revealed no connection with any of the 6 most common global serogroups responsible for epidemic incidence rise (A, B, C, W-135, X, Y). A clear tendency for prevalence of S. pyogenes DNA in adenoid pediatric biopsies in children diagnosed with “Adenoids and tonsils hypertrophy” vs. “Adenoids hypertrophy” was observed. It is noteworthy, a high relative prevalence of pneumococcal carriage (87.5%), found by us was of special importance. Pediatric carriers serving as a reservoir for virulent pneumococcal species pose a threat both for themselves and surrounding people. Thus, PCR-based data of adenoid biopsies may be a promising approach for future studies, as a potential to identify live viable but nonculturable bacteria in clinical specimens will contribute to a more accurate assessment of carriage rate of meningococci, pneumococci, H. influenzae and group A streptococci.

Helicobacter pylori Colonization in Patients with Adenotonsillar Hypertrophy: Study on Prevalence and Clinical Characteristics of Colonized Patients and Possible Association with Complications

Background: Adenotonsillar hypertrophy (ATH) is a common problem in children that causes the obstruction of airways and other relevant complications. Helicobacter pylori (H. pylori) is considered one of the microbial causes of ATH development. Objectives: The study aimed to determine the H. pylori colonization in patients with adenotonsillar hypertrophy and assess the prevalence and clinical characteristics of colonized patients and possible association with complications. Methods: This study was carried out on 114 children with ATH referring to the Bouali Hospital of Sari from December 2017 to December 2018. Adenotonsillar samples were prepared from the right and left tonsils and adenoid of each patient. The Rapid Urease test (RUT) and nested-PCR were performed on the samples. Data analysis was performed with SPSS version 20 software. Results: The participants included 52 females and 62 males with a mean age of 7.19 ± 3.08 years. The RUT was positive for 59 participants: 26 in right tonsil, 31 in left tonsil, and two in adenoid samples. Helicobacter pylori was detected in the adenotonsillar tissue of 95 patients using nested-PCR. No significant association was found between the PCR results and gender (P = 0.123). Conclusions: This study approved the presence of H. pylori in the adenotonsillar tissue of children with ATH and highlighted the concept that the pharynx could be an extra gastric reservoir of H. pylori. However, we failed to prove an association between H. pylori adenotonsillar colonization with ATH and acute otitis media.

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

Chronic adenoiditis leading to adenoid hypertrophy is common in children. Many cases would also have co-existing chronic rhinosinusitis (CRS). Infact, long lasting bacterial infection of the adenoids has been hypothesized to be the cause for CRS in these children. A cross-sectional study was conducted in the departments of ENT and Micro-biology at Kasturba Hospital, Manipal, India between 2016 and 2017. 20 subjects who were diagnosed with CRS and adenoid hypertrophy took part in the study. Aerobic, anaerobic and fungal culture sensitivity of adenoid tissue was done along with aerobic and fungal culture sensitivity of nasal swabs from middle meatus. 2 out of 20 adenoid samples showed positive culture for aerobes and 19 adenoid samples grew anaerobic organisms. 7 out of 20 nasal swabs grewsomeaerobes and 2 were positive for fungal organisms. The correlation of microorganisms between adenoid hypertrophy and CRS was seen only in one patient in which methicillin resistant Staphylococcus aureus was grown. The present study showed mixed flora in the adenoid samples with anaerobic predominance. Aerobes were predominantly grown in nasal swabs from patients with CRS along with fungal colonizers. Though the study does not establish any bacteriological association with the CRS in our cohorts, the significant growth of the anaerobes from the core of the inflamed adenoids has prompted us to suggest the inclusion of the antibiotics against the anaerobes in the medical management of these children, whenever feasible. We think the addition of specific antibiotics to tackle anaerobes helps by hampering the further inflammatory hypertrophy of adenoid tissue.

IL-17C expression and its correlation with pediatric adenoids: a preliminary study.

Objective: Interleukin-17 (IL-17) C is a cytokine expressed by epithelial cells in response to bacterial stimulation. In contrast to other members of the IL-17 family of cytokines, IL-17C is upregulated early during infection, maintains integrity of the epithelial layer barrier, and mediates the innate immune response. We investigated the expression profile of IL-17C in pediatric adenoids.Methods: Pediatric adenoid tissues and lavage fluids were collected from a total of 38 subjects. The Limulus amebocyte lysate test and real-time PCR using Staphylococcus aureus primers were performed to evaluate bacterial contents in adenoids. Expression of IL-17RE in adenoids was analyzed using real-time polymerase chain reaction and western blot. The expression of IL-17C was evaluated by western blot and immunohistochemistry and compared between allergic rhinitis (AR) and control subjects. The levels of Hsp27, Hsp70, and IL-17C in adenoid lavage fluids were evaluated by enzyme-linked immunosorbent assay, and the correlation between these molecules was statistically analyzed.Results: The pediatric adenoids were found to be exposed to bacteria and had a normal flora comprising both gram-negative and -positive bacteria. IL-17RE, an IL-17C specific receptor, was highly expressed in the epithelium of adenoids. IL-17C was expressed in all evaluated adenoid tissue samples, irrespective of the allergic status of the patient. IL-17C secretion was detected in half of the adenoid lavage fluid samples and was associated with Hsp70 level.Conclusion: Our findings indicate the possible role of pediatric adenoids in innate immunity modulation via an innate immunity-associated cytokine.