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Relationship between bacteriology of the adenoid core and middle meatus in children with sinusitis

Published online by Cambridge University Press:  13 December 2010

S Elwany ,
A N El-Dine ,
A El-Medany ,
A Omran ,
Z Mandour  and
A Abd El-Salam
S Elwany*
Affiliation:
Department of Otolaryngology, Alexandria Medical School, Egypt
A N El-Dine
Affiliation:
Department of Microbiology, Alexandria Medical School, Egypt
A El-Medany
Affiliation:
Department of Otolaryngology, Alexandria Medical School, Egypt
A Omran
Affiliation:
Department of Otolaryngology, Alexandria Medical School, Egypt
Z Mandour
Affiliation:
Department of Otolaryngology, Alexandria Medical School, Egypt
A Abd El-Salam
Affiliation:
Department of Otolaryngology, Alexandria Medical School, Egypt
*
Address for correspondence: Dr Samy Elwany, 4 Kfr Abdou Street, Roushdey, Alexandria, Egypt Fax: +2034872665 E-mail: [email protected]
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Abstract

Objective:

To assess the correlation between bacterial pathogens in the adenoid core and the middle meatus, in children with hypertrophied adenoids and chronic or recurrent sinusitis.

Design:

The study was conducted at Alexandria University Hospitals. We included 103 children aged four to 12 years who were scheduled for adenoidectomy and who had clinical and/or radiological evidence of chronic or recurrent sinusitis. Adenoid core specimens and middle meatal swabs were obtained from every patient and were sent for bacteriological evaluation using standard qualitative and quantitative microbiological techniques. The results were statistically analysed.

Results:

The bacterial species isolated most frequently from the adenoid core were coagulase-negative staphylococci (40.8 per cent), Staphylococcus aureus (22.3 per cent), Streptococcus pneumoniae (18.4 per cent), Haemophilus influenzae (16.5 per cent) and group A streptococci (15.5 per cent). The bacterial species isolated most frequently from the middle meatus were coagulase-negative staphylococci (41.7 per cent), S aureus (32 per cent), S pneumoniae (28.1 per cent), H influenzae (21.6 per cent) and group A streptococci (19.4 per cent). The adenoid core and middle meatal cultures were both positive for at least one bacterial species in 63 cases, and were both negative in 25 cases. In six cases, a positive adenoid core culture was associated with a negative middle meatal culture. In five cases, a negative adenoid core culture was associated with a positive middle meatal culture (for one or more pathogenic species). Thus, adenoid core culture had a positive predictive value of 91.5 in forecasting the middle meatal culture result, and a negative predictive value of 84.3.

Conclusion:

Apart from its effect on nasal airway patency, adenoidal tissue may function as a bacterial reservoir initiating and maintaining sinus infection in children. These study findings support a potential role for adenoidectomy in the treatment of chronic or recurrent paediatric sinusitis.

Keywords

AdenoidsNasal CavitySinusitisChildBacteriology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 3 , March 2011 , pp. 279 - 281
Copyright
Copyright © JLO (1984) Limited 2010

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