Bacteriology of adenoids and tonsils in children with recurrent adenotonsillitis

Adenoids and tonsils electively removed from 25 children with a history of recurrent group A beta -hemolytic streptococci (GABHS) adenotonsillitis wer e cultured for aerobic and anaerobic bacteria. Two hundred twenty-four orga nisms (112 aerobes and facultatives, 110 anaerobes, and 2 Candida albicans) were isolated from the tonsils, and 229 (111 aerobes and facultatives and 118 anaerobes) were isolated from the adenoids. Mixed infection was present in all instances, with an average of 9.1 isolates per specimen. The predom inant aerobes were Streptococcus sp, Haemophilus influenzae, and GABHS, and the prevalent anaerobes were Peptostreptococcus, Prevotella, and Fusobacte rium spp. beta -Lactamase-producing bacteria were detected in 72 isolates r ecovered from 22 tonsils (88%) and in 74 isolates recovered from 21 adenoid s (84%). Discrepancies in the organisms recovered were found between the to nsils and adenoids. Of the aerobic isolates, 20% were isolated only in tons ils and 18% only in adenoids. Of the anaerobes, 20% were found only in tons ils and 26% only in adenoids. This study demonstrates a polymicrobial aerob ic-anaerobic flora in both adenoids and tonsils, and discrepancies in recov ery of pathogens such as GABHS. The adenoids may serve as a potential sourc e of tonsillitis caused by GABHS.