Unusual infections in resected adenoid of children: PCR for C. pneumonia, M. pneumonia, H. pylori.

Abstract

Abstract. Recurrent or chronic adenotonsillar infections mainly affect children.The possible role for infectious agents in adenoid hypertrophy have reported. Searching the DNAs (PCR) of M. pneumonia, C. pneumonia and H. pylori in resected adenoid of children with adenoid surgery. A cross-sectional study done in ENT and Pediatric Department of Rasul Akram Hospital during 2006-2008. 53 children with recurrent or chronic adenotonsillar infections candidate for adenoid surgery were selected .The resected adenoid tissues (1cm) during surgery removed by surgeon. The tissue samples were centrifuged and homogenized, DNAs were extracted and searched for DNAs of M. pneumonia, C. pneumonia and H. pylori by qualitative PCR. Mean age of cases was 8 ±1.9 years. 48% male; 51.9% female 23%. Most cases aged between 6-9 years (71.5%). Most adenoid surgery was done in winter (32%). M. pneumonia- DNA detected in 28%; C. pneumonia in 13.2%; H. pylori in 15% of tissue samples with no relation to   sex and age of cases. Most positive PCR results for C. pneumonia and H. pylori (p=0.05; 0.02) were seen in spring and summer but not for M. pneumonia ( p=0.5) We could detect at least 1 of these 3 unusual infectious agents (M. pneumonia, C. pneumonia and H. Pylori) in adenoid tissues of 60% cases. These unusual infections may have a relative role in etiology of adenoid hypertrophy. Chronic sinusitis and ear infection might be added to infected adenoid tissue as a reservoir for these unusual bacteria. The search by more specific method such as Real time-PCR; or specific culture may elucidate better the role of these unusual infections in adenoid hypertrophy in future. The decision for use of antibiotics to eradicate these unusual infections in recurrent or chronic adenotonsillar infections before adenoid surgery (with or without rhinosinusitis or chronic ear infection) needs Randomized Controlled Trial studies.

Key words: Adenoid tissue; Adenoid hypertrophy; C. pneumonia; M. pneumonia; H. pylori  

Keywords

• Adenoid tissue, Adenoid hypertrophy, C. pneumonia, M. pneumonia, H. pylori

Kaynakça

1. 1. Tuncer U, Aydogan B, Soylu L, et al. Chronic rhinosinusitis and adenoid hypertrophy in children. Am J Otolaryngol 2004; 25: 5-10.
2. 2. Shatz A. Indications and outcomes of adenoidectomy in infancy. Ann Otol Rhinol Laryngol 2004; 113: 835-838.
3. 3. Bernstein JM, Dryja D, Murphy TF. Molecular typing of paired bacterial isolates from the adenoid and lateral wall of the nose in children undergoing adenoidectomy: implications in acute rhinosinusitis Otolaryngol Head Neck Surg 2001 125: 593-597.
4. 4. Brook I, Shah K. Bacteriology of adenoids and tonsils in children with recurrent adenotonsillitis. Ann Otol Rhinol Laryngol 2001; 110: 844-848.
5. 5. Cirak MY, Ozdek A, Yilmaz D, et al. Detection of H.pylori and its CagA gene in tonsil and adenoid tissues by PCR.Arch Otolaryngol Head Neck Surg 2003; 129: 1225-1229.
6. 6. Cultrara A, Goldstein NA, Ovchinsky A, et al. The role of Chlamydia pneumoniae infection in children with chronic sinusitis. Arch Otolaryngol Head Neck Surg 2003; 129: 1094-1097.
7. 7. Storgaard M, Tarp B, Ovesen T, et al. The occurrence of C. pneumonia, M.pneumonia, and herpesviruses in otitis media with effusion. Diagn Microbiol Infect Dis 2004; 48: 97-99.
8. 8. Sprinkle PM, Kirk BE, Mathias PB. Mycoplasma species found in naturally occurring adenotonsillitis. Arch Otolaryngol Head Neck Surg 1993; 119: 1043-1044.

9. 9. Engstrand I, Augustsson I, Bergemalm PO, et al. Demonstration of C.pneumonia in the adenoid from children with and without secretory otitis media using immunohistochemistry and PCR. Scand J Infect Dis 2001; 33: 132-136.
10. 10. Normann E, Gnarpe J, Nääs J, et al. Chlamydia pneumoniae in children undergoing adenoidectomy. Acta Paediatr 2001; 90: 126-129.
11. 11. Ozdek A, Cirak MY, Samim E, et al. A possible role of Helicobacter pylori in chronic rhinosinusitis: a preliminary report Laryngoscope 2003; 113: 679-682.
12. 12. Dagli M, Eryilmaz A, Uzun A, Kayhan B, Karabulut H. Investigation of Helicobacter pylori in the middle ear of the patients with chronic otitis media by CLO test and 14C urea breathe test. Otol Neurotol 2006; 27: 871-873.
13. 13. Skinner LJ, Winter DC, Curran AJ, et al. Helicobacter pylori and tonsillectomy. Clin Otolaryngol 2001; 26: 505-509.
14. 14. Agirdir BV, Bozova S, Derin AT, Turhan M. Chronic otitis media with effusion and H.pylori.Int J Pediatr Otorhinolaryngol 2006; 70: 829-834.
15. 15. Saffari M, Motavalii MA, Fazeli A. Immunoblot Assay in Determination of Serum Antibody Profile of H.Pylori Infection. Iran J Med Sci 2003; 28: 90- 93.
16. 16. Khademi B, Imanieh B, Gandomi B, Yeganeh F, Niknejad N. Investigation of H Pylori Colonization in Adenotonsillectomy Specimens by Means of Rapid Urease (CLO) Test. Iran J Med Sci 2005; 30: 138-140.
17. 17. Masoodpoor N, Darakhshan, Sheikhvatan M. Helicobacter pylori infection in Iranian children with recurrent abdominal pain.Trop Gastroenterol 2008; 29: 221-223.
18. 18. Baghaei K, Shokrzadeh L, Jafari F, et al. Determination of Helicobacter pylori virulence by analysis of the cag pathogenicity island isolated from Iranian patients. Dig Liver Dis 2009 Mar 2. (Epub ahead of print)
19. 19. Nouraie M, Latifi-Navid S, Rezvan H, et al. Childhood hygienic practice and family education status determine the prevalence of H. pylori infection in Iran.Helicobacter 2009; 14: 40-46.
20. 20. Noorbakhsh S, Farhadi M, Tabatabaei A, Zarabi V. Whats the role of C. Pneumonia in rhinosinusiits of children? Acta Medica Iranica 2009; 47: 279-284.
21. 21. Noorbakhsh S, Javahertarash N, Rimaz Sh, Rezaei M. Comparative study of C. pneumonia infection in children with pneumonia in compare with normal children in Rasul Akram hospital. Iran University of Medical Sciences 2004; 43: 855-860.
22. 22. Tabatabaee A, Farhadi M, Nourbakhsh S, Shekarabi M, Shamshiri AR. Evaluation of Mycoplasma ad Chlamydia infection with PCR method and Serology in patients with nasal polyps and normal subjects. Iran University of Medical Sciences 2009; 15: 133-139.
23. 23. Ahmadi Torshizi A, Tohidi M, Attaran D, Khaje Karamadin M, Ghazvini K. Role of Chlamydia pneumoniae infection in asthma in Northeast of Iran. Iran J Allergy Asthma Immunol 2008; 7: 45- 46.
24. 24. Kumar S, Hammerschlag MR. Acute respiratory infection due to Chlamydia pneumoniae: current status of diagnostic methods. Clin Infect Dis 2007; 44: 568-576.