ABSTRACT
The aim of this study was to analyze the prevalence of Staphylococcus aureus in the tonsils of children subjected tonsillectomy due to recurrent tonsilitis and to determine the spa types of the pathogens, carriage of virulence genes and antimicrobial resistance profiles. The study included 73 tonsillectomized children. Bacteria, including S. aureus were isolated from tonsillar surface prior to tonsillectomy, recovered from tonsillar core at the time of the surgery, and from posterior pharynx 2-4 weeks after the procedure. Staphylococcus aureus isolates were compared by spa typing, tested for antimicrobial susceptibility and for the presence of superantigenic toxin genes (sea-seu, eta, etb, tst, lukS/lukF-PV) by multiplex polymerase chain reaction. Seventy-three patients (mean 7.1 ± 4.1 years, 61.6% male) were assessed. The most commonly isolated bacteria were S. aureus. The largest proportion of staphylococcal isolates originated from tonsillar core (63%), followed by tonsillar surface (45.1%) and posterior pharynx in tonsillectomized children (18.2%, p = 0.007). Five (6.3%) isolates were identified as MRSA (mecA-positive). Up to 67.5% of the isolates synthesized penicillinases (blaZ-positive isolates), and 8.8% displayed MLSB resistance. The superantigenic toxin genes were detected in more than half of examined isolates (56.3%). spa types t091, t084, and t002, and clonal complexes (CCs) CC7, CC45, and CC30 turned out to be most common. Staphylococcus aureus associated with RT in children showed pathogenicity potential and considerable genetic diversity, and no clones were found to be specific for this condition although further studies are needed.
Subject(s)
Drug Resistance, Bacterial/genetics , Genetic Variation/genetics , Staphylococcus aureus/genetics , Tonsillitis/microbiology , Adolescent , Anti-Infective Agents/therapeutic use , Child , Child, Preschool , Female , Humans , Male , Microbial Sensitivity Tests/methods , Palatine Tonsil/microbiology , Prevalence , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Staphylococcus aureus/drug effects , Tonsillectomy/methods , Tonsillitis/drug therapy , Virulence/genetics , Virulence Factors/geneticsABSTRACT
INTRODUCTION: The stapedius nerve is one of the branches of the facial nerve in the temporal bone. It supplies the stapedius muscle, which is responsible for the attenuation reflex that protects the inner ear from loud noises. The stapedius (acoustic) reflex (SR) test is useful in identifying the site of facial nerve injury. The return of the SR (acoustic) to normal after an injury is a good prognostic factor in the treatment of facial nerve palsy. OBJECTIVE: The aim of this study was to evaluate the effect of FNP on the SR (acoustic) response and determine the acoustic reflex threshold (ART) levels on the affected side. MATERIAL AND METHOD: In this study, 70 patients, 3-7 years old, were screened. The study population consisted of 26 boys (37%) and 44 girls (63%). Follow-up tests were performed 3-18 months after the initial tests. RESULTS: Most patients in the study population had a negative SR (acoustic) response on the affected side. In other patients, mean ART values were statistically higher on the affected side. There was no statistically significant relationship between a reflex response and the time from the onset of facial nerve palsy. DISCUSSION: In the available literature, the SR (acoustic) testing is limited in determining whether or not the reflex is present without stimulus frequency or ART measurements. It is estimated that the reflex response is negative with ipsilateral stimulation on the affected side in 35-80% patients. CONCLUSIONS: The SR (acoustic) is absent in most patients on the affected side. The ART value was statistically higher on the affected side. The SR (acoustic) response was statistically time independent.
Subject(s)
Facial Paralysis/physiopathology , Reflex, Acoustic/physiology , Stapedius/physiopathology , Acoustic Impedance Tests , Child , Child, Preschool , Female , Humans , MaleABSTRACT
Cerebellar abscess is a serious complication of ear disease that requires early diagnosis and treatment. Computerized axial tomography with contrast enhancement is very useful for the diagnosis of these abscesses. This fact is illustrated by a case report of a cerebellar abscess secondary to chronic otitis media with cholesteatoma detected in one of our patients. On examination otorrhoea, fever, headache, vomiting and had hemilateral conductive hearing loss. The therapy included radical operation, excision of the abscess and antibiotic therapy.
