Post-Tonsillectomy Associated Bacteremia


Abstract:Objective: to identify the causative microorganisms of tonsil surface and core in patients with chronic tonsillitis, and whether these microorganisms carry the risk of bacteremia during tonsillectomy.Patients & methods: thirty five patients admitted to Al-Ramadi General Hospital from September 2002-March 2003, they suffered from chronic tonsillitis and they prepared for tonsillectomy. Tonsil surface and core swabs were taken for culture at the time of operation, and venous blood samples were taken for culture before and one hour after the procedure provided no antibiotics were taken two weeks before the operation. The cultures were performed under aerobic, facultative anaerobic and anaerobic conditions. All isolated organisms were well bacteriologically identified and confirmed by using biochemical tests.Results: surface and core cultures of the thirty five case represented multiple microorganisms. Gram positive cocci were the commonest organisms from the surface 28(70%) and core 18(85.8%), while Gram negative bacilli represented the remaining organisms. Among those Gram positive cocci, Streptococcus pyogenes were the commonest organisms isolated from the surface 15(37.5%) and core 14(66.8%). No reproduction was observed regarding the blood cultures taken before the procedure. Bacteremia was found in blood samples of seven patients(20%) taken after tonsillectomy. The commonest organisms were streptococcus Pyogenes 3(42.8%), followed by pseudomonas aeruginosa 2(28.6%).Conclusion: the study suggested that aerobic and anaerobic organisms were present among tonsil surface and core cultures and bacteremia may developed after tonsillectomy. Therefore, to avoid the possible dramatic outcomes after tonsillectomy the required measures during the preoperative period should be taken into consideration, especially in patients that have chronic tonsillitis with cardiovascular disease. Key Words: Tonsil surface and core microbiology, Bacteremia, tonsillectomy.