Adherent biofilms in adenotonsillar diseases in children.

OBJECTIVE To study biofilm formation on the epithelial surfaces of tonsils and adenoids in children undergoing adenotonsillectomy (T&A). DESIGN Prospective study. SETTING Tertiary academic hospital. PATIENTS Between September 2005 and August 2006, 76 patients (mean [SD] age, 5.7 [3.3] years; age range, 1-18 years; male-female ratio, 1.8:1) undergoing T&A to treat infection, obstruction, or both were included. Of these, 44 had obstruction (58%), 26 had infection (34%), and 6 had both (8%). INTERVENTIONS Scanning electron microscopy was used to assess for the presence of biofilms. MAIN OUTCOME MEASURE Presence of adherent biofilms on the surface epithelium of tonsils and adenoids. RESULTS Adherent biofilm formation was demonstrated in 46 patients (61%). Among 26 patients with infections, adherent biofilm formation was detected in 22 (85%), whereas in the group of 44 patients with obstruction only 18 were found to have biofilms (41%). Comparative analysis of the data revealed that the difference was statistically significant (P = .01). CONCLUSIONS Biofilms were identified on the surfaces of infected or enlarged tonsils and adenoids in most patients undergoing T&A. The presence of biofilms in a significantly higher proportion of patients with chronically inflamed tonsils and adenoids vs patients with obstruction indicates an association between the presence of biofilms and chronic inflammation.