TONSIL SURFACE AND CORE CULTURES IN RECURRENT TONSILLITIS - PREVALENCE OF ANAEROBES AND BETA-LACTAMASE-PRODUCING ORGANISMS

The bacterial flora of the tonsil surface and core was compared in pat ients suffering from recurrent tonsillitis. Surface swabs and tonsil c ore tissues were received as paired samples from 50 patients admitted for elective tonsillectomy. Analysis of paired samples from individual patients revealed differences in the bacterial flora of the tonsil co re and the tonsil surface. Of 366 aerobic isolates, 30 % grew from the surface alone, 26 % from the core only and 44 % from both sites. Of 2 90 anaerobic isolates, 35 % grew from the surface alone, 33 % from the core only and 31 % from both sites. The total number of isolates from surface and core samples was similar (average 9.2 and 8.8, respective ly). The range of species isolated was also similar for both surface a nd core samples, as was the proportion of organisms producing beta-lac tamase from each site (10.7 % and 9.5 %, respectively). Eighty-two per cent of patients carried beta-lactamase-producing organisms on either the tonsil surface or in the core tissue. A surface swab does not reli ably reflect the types of organisms present in the tonsil core in indi vidual patients. Anaerobes are a major component of tonsil surface and core bacterial flora in patients with recurrent tonsillitis. The high carriage rate of beta-lactamase-producing organisms in the tonsils sh ould be considered when selecting antimicrobial therapy for persistent or recurrent tonsillitis.