Microbiological and morphological aspects of chronic tonsillitis
The objective. To establish the role of the infectious (microbial) factor in the development of pathomorphological changes in palatine tonsils in patients with a decompensated form of chronic tonsillitis (CT). Patients and methods. The examination included 102 patients with a decompensated form of CT. Material for microflora examination was taken from the surface of mucous membranes of palatine tonsils and the procedure was repeated after tonsilectomy from deep parts of the lacunae of the tonsils. Isolation and identification of pathogens was performed on a microbiological analyzer Vitec (USA). Results. We isolated 48 kinds of microorganisms represented by 8 groups: streptococci, staphylococci, micrococci, enterobacteria, nonfermenting gramm-negative bacteria, enterococci, mesophiles, fungi of the genus Candida. Morphological assessment of the activity of inflammation and the stage of chronic process in tonsils was performed according to the elaborated criteria. As was found, tonsils are a reservoir for conditionally pathogenic microflora, the spectrum of which on the surface and in the depth differs significantly. The most active participants of infectious process in the tonsils are representatives of staphylococci, enterobacteria and the family of mesophilic fungi isolated from the depth of tonsils. Conclusion. The development of infectious process in tonsils and their involution are influenced by nonfermenting grammnegative bacteria and pathogens of the mesophilic family that for a long time persist in deep parts of the tonsils. The process of sclerosing of tonsils is related to persistent mixed pathogens represented by enterococci, mesophiles, fungi of the genus Candida and their associations with streptococci, staphylococci, and micrococci.