THE PROFILE OF MICROORGANISMS THAT ASSOCIATE

WITH ACUTE TONSILLITIS IN CHILDREN AND THEIR

ANTIBIOTICS SENSITIVITY PATTERN IN NIGERIA.

Ughasoro Maduka Donatus1, Akpe James Onuorah2, Echendu

Nneamaka3, Ezeokeke Chinelo Onyinye1 Mgbachi Nneka Gertrude4,
Okpala Somkene3, Amah Linda3, Okolo Onyinye Henrietta5, Udem
Ngozika6,
 INTRODUCTION
• A common childhood disease in developing countries.

• Diagnosis is often clinical with empirical treatment commenced.

• Antimicrobial susceptibility pattern improves treatment outcome.

• This study aimed to determine the pattern of microbiota isolates and their
susceptibility pattern.
 METHODOLOGY
• Study sites: UNTH, Enugu and FMC, Umuahia.

• The study design: Retrospective and cross-sectional method.

• The medical records of children treated for tonsillitis were reviewed and
children with acute tonsillitis were recruited with Interviewer-administered
questionnaire.

• Swab sample was taken for culture and antibiotic susceptibility test.
 RESULT
0.042 3
Escherichia0.014
coli 1
0.014 1
0.028 2
Moraxella catalitis
0.028 2
0.069
Pseudomonas species 5
0.069 5
0.139
Proteus species 10
0.153 11
0.153
Staphylococcus aureus 11
0.403 29
Swab Culture Isolates (n=72)
0 5 10 15 20 25 30 35
Series2 Series1

Figure 1. The Microbiota isolates from the swab culture

 RESULT
Table 1. The Antibiogram susceptibility and resistant pattern of the microbiota isolates

Sensitivity Imipene Levoflo Ceftriax Azithro Amoxicilli Cefexin Ampici

Isolates pattern m xacin one mycin n- e llin
Clavulanic
Staphylococcus aureus
(n=11) Sensitive 9 11 7 6 8 8 4
Resistant 2 0 4 5 3 3 7
Streptococcus species
(n =13) Sensitive 13 11 13 9 5 4 2
Resistant 0 2 0 4 8 9 11
Proteus(n=10) Sensitive 10 7 3 5 2 2 0
Resistant 0 3 7 5 8 8 10
Klebsiella(n = 5) Sensitive 5 3 3 3 0 0 0
Resistant 0 2 2 2 5 5 5
Pseudomonas
(n = 5) Sensitive 5 4 3 1 2 2 1
Resistant 0 1 2 4 3 3 4
Morexella catalalis
(n = 2) Sensitive 2 0 2 2 2 0 0
Resistant 0 2 0 0 0 2 2
E.coli(n = 1) Sensitive 1 1 1 1 1 1 1
Resistant 0 0 0 0 0 0 0
Summed 45 37 32 27 20 17 8
Sensitivity (95.7%) (78.7%) (68.1%) (57.4%) (42.6%) (36.3%) (17%)
Summed 2 10 15 20 27 30 39
Resistant
 DISCUSSION
• A significant percentage of the swab culture yielded no significant
growth.

• Posterior pharyngeal wall yields more positive culture than tonsillar

surface.

• Majority of cases do not require antibiotic treatment.

• Treatment should be as in-patient using parenteral medications.

 CONCLUSION
• The proportion of the positive isolates that were
Streptococcus spp was small.

• Strong approach towards effective implementation of

antibiotic stewardship.
 REFERENCES
1. Snow RW, Marsh K: Malaria in Africa: progress and prospects in the decades since the Abuja
declaration. Lancet 2010, 376:137-39.
2. World Health Organization: African Summit on Roll Back Malaria. Abuja, Nigeria.
WHO/CDS/RBM/2000.17. Geneva: WHO; 2000.
3. Tarimo DS, Minjas JN, Bygbjerg IC: Malaria diagnosis and treatment under the strategy of the
integrated management of childhood illness (IMCI): relevance of laboratory support from the rapid
immunochromatographic tests of ICT malaria P.f/P.v and OptiMal. Ann Trop Med Parasitol 2001,
95:437-443.
4. Rolland E, Chechi F, Pinoges L, Balkan S, Guthmann JP, Guerin PJ: Operational response to
malaria epidemics: are rapid diagnostics test cost-effective? Trop Med Int Health 2006, 11:398-
408.
5. Moody A: Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev 2002, 15:66-78.
6. Makler MT, Palmer CJ, Ager AL: A review of practical techniques for the diagnosis of malaria.
Ann Trop Med Parasitol 1998, 92:419-433.