Bacterial biofilm and its relation to cervical adenopathy, tonsillar hypertrophy and adenoid hypertrophy in chronic tonsillitis

Background: Bacterial biofilms have been linked to recurrent adenotonsillar diseases, with special concern regarding therapeutic management hindered by antibiotic resistance. Aims: we aimed to find if there was a relationship between the presence of a bacterial biofilm and the development of cervical lymphadenopthy, tonsillar hypertrophy and adenoid hypertrophy in patients with chronic tonsillitis. Patients and Methods: Tissue samples from tonsillar biopsies of 30 children who underwent tonsillectomy were examined by scanning electron microscopy (SEM). Settings and Design: This cross-sectional study was conducted between August 2012 and July 2015 in Al-Azhar University Hospitals. Results: It was found that 23.3% of children had a fully formed bacterial biofilm (Grade III), 6.7% had grade I and 6.7% had grade II biofilms as demonstrated by SEM. Staphylococcus aureus was the most common identified isolate (26%) followed by Coagulase-negative Staphylococci (17.4%) and Klebsiella pneumoniae (10.4%). No statistically significant difference regarding the presence of a bacterial biofilm and the development of cervical lymphadenopthy, tonsillar hypertrophy or adenoid hypertrophy was found. Conclusion: Bacterial biofilm is a possible cause of the chronicity of tonsillar diseases in children. There is no relationship between the presence of a bacterial biofilm and the development of of cervical lymphadenopthy, tonsillar hypertrophy or adenoid hypertrophy.