Posted in Volume 15 - Number 4
SALMAN MUTIULLAH SHAIKH, MAHBOOB AFZAL JAWAID, NAILA TARIQ, M. UMAR FAROOQ
ABSTRACT | Full Text PDF
OBJECTIVE: To find out the most common organism affecting the surface and core of tonsil, in patients with recurrent tonsillitis undergoing tonsillectomy.
STUDY DESIGN: Descriptive study.
SETTING: E.N.T department, DUHS & Civil Hospital Karachi.
METHODS: In 2008, 67 patients with recurrent tonsillitis were selected for study. Surface swabs were taken before, while tonsil core swabs were taken after tonsillectomy and specimens sent with in an hour to laboratory for inoculation on to five percent sheep blood, chocolate, and MacConkey agar. Statistical analysis carried out using SPSS, version 10.
RESULTS: In 67 patients, mean age was 13.04 ± 6.47 years. The most common surface organisms found were Streptococcus pneumoniae and that from the core were Staphylococcus aureus and Streptococcus pneumoniae. Among 80.59 % pathogenic organisms, 46.29 % found only in tonsil core (P=0.003). Staphylococcus aureus was the most common pathogen and significantly (43.75 %) found only in tonsil core (P<0.05), while next pathogen was group A, β hemolytic streptococci and its significant (45.45 %) cases also found only in tonsil core (P<0.05). Throat swab has 47.91 % sensitivity, 68.84 % specificity, and 79.31 % positive predictive value in diagnosis of chronic tonsillitis.
CONCLUSION: In recurrent tonsillitis patients, surface swab is not a very good predictor of core organisms. Staphylococcus aureus and group A, β hemolytic streptococci found to be most common pathogens. While Streptococcus pneumoniae and Staphylococcus aureus were the most common surface organisms. This study shows importance of core sampling of tonsils to indicate right reflection of infection.
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