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Association of adenoid hyperplasia and bacterial biofilm formation in children with adenoiditis in Taiwan

European Archives of Oto-Rhino-Laryngology volume 269, pages 503–511 (2012)Cite this article

Abstract

The adenoid is a bacterial reservoir that contributes to chronic otolaryngologic infections. Staphylococcus aureus (S. aureus) is a common pathogen in the adenoid. The increase of antibiotic resistance in S. aureus has become an important issue in public health. The aim of this study was to compare adenoid hyperplasia and biofilm formation in children with S. aureus adenoiditis in Taiwan. The patients were divided into methicillin-resistant and methicillin-sensitive S. aureus groups according to the S. aureus obtained from adenoid tissue after antibiotic susceptibility testing. Adenoid hyperplasia was assessed by lateral cephalometry, and the severity of sinusitis was evaluated by Water’s view. Microbiological investigation of available S. aureus isolates was performed by in vivo morphological observation and an in vitro bacterial biofilm assay. Sixty isolates of S. aureus were identified in 283 children (21.2%) after adenoidectomy, of which 21 (35%) were methicillin-resistant S. aureus (MRSA). The severity of adenoid hyperplasia and extensive biofilm formation were more prominent in patients infected with methicillin-resistant S. aureus than in those infected with methicillin-sensitive S. aureus (MSSA). The primary outcome of this study was to provide evidence that S. aureus constituted a significant portion of the adenoidal pathogens. The secondary outcome of this study was that MRSA adenoiditis may be associated with adenoid hyperplasia and biofilm formation.

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Acknowledgments

We thank Drs. Hui-Lan Chang, Wen-Tze Chen, and I-Hsun Liu (Departments of Laboratory Medicine, China Medical University Hospital) for clinical isolation and identification of bacterial strains. This work was supported by research grants from the National Science Council (NSC98-2314-B-039-024-MY3), Taiwan, the China Medical University Hospital (DMR98-029, CMU98-S-09, DMR100-043), and Clinical Trial and Research Center of Excellence Funds (DOH100-TD-B-111-004) from the Taiwanese Department of Health, and the Tomorrow Medicine Foundation.

Conflict of interest

None declared.

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Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan

    Chia-Der Lin, Chin-Yuan Wang, Yung-An Tsou & Ming-Hsui Tsai

  2. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan

    Chia-Der Lin & Ming-Hsui Tsai

  3. School of Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan

    Mang-Hung Tsai, Mao-Wang Ho, Yung-An Tsou & Chih-Ho Lai

  4. Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan

    Cheng-Wen Lin

  5. University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA

    Chih-Ho Lai

  6. Department of Biological Science and Technology, China Medical University, Taichung, Taiwan

    Ming-Ching Kao

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  1. Chia-Der Lin
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  2. Mang-Hung Tsai
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Correspondence to Ming-Hsui Tsai or Chih-Ho Lai.

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Lin, CD., Tsai, MH., Lin, CW. et al. Association of adenoid hyperplasia and bacterial biofilm formation in children with adenoiditis in Taiwan. Eur Arch Otorhinolaryngol 269, 503–511 (2012). https://doi.org/10.1007/s00405-011-1704-x

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  • DOI: https://doi.org/10.1007/s00405-011-1704-x

Keywords

  • Adenoid
  • Biofilm
  • Staphylococcus aureus
  • Antibiotic resistance