Microbiology of peritonsillar abscess in the South Estonian population

Figures & data

Table 1 Clinical data

Antimicrobial therapy before admission	16 (72.7%)
	6 female (27.3%) and 16 male (72.7%)
Gender	Median	Range
Age	32	14–74 years
Fever	38.4°C	37.1°C–39.1°C
Organisms from tonsillar fossa	6	1–10
Organisms from pus	3	0–9
Average tonsillitis episodes per year	0	0–10
Length of previous history of tonsillitis	0	0–5 years
Index of tonsillitis	0	0–36
Sclerotic signs	4	0–5

Fig. 1 Patient culture results and their locations.

Table 2 Microorganisms isolated from the pus, tonsillar fossa, and blood of peritonsillar abscess patients

Phylum	Family	Bacteria	Pus	Tonsillar fossa	Blood
Proteobacterium	Comamonadaceae	Acidovorax temperans	1
	Moraxellaceae	Moraxella/Branhamella catarrhalis		1
	Pasteurellaceae	Aggregatibacter aphrophilus	1
		Haemophilus influenzae		1
		Haemophilus parainfluenzae		2
	Neisseriaceae	Neisseria flavescens	1	7
		Neisseria macacae	4
		Neisseria mucosa/macacae		2
		Neisseria perflava	2	5
		Neisseria perflava/flavescens		3
		Neisseria subflava	1	1
		Neisseria spp.		1
Firmicutes	Bacillaceae	Bacillus licheniformis		1
	Carnobacteriaceae	Granulicatella adiacens	1	1
	Clostridiaceae*	Clostridium halophilum	2	3
		Parvimonas micra	2	1
		Peptostreptococcus anaerobius			1
	Lactobacillaceae	Lactobacillus catenaformis	2
		Lactobacillus fermentum	1
		Lactobacillus plantarum		1
	Staphylococcaceae	Gemella haemolysans		1
		Gemella haemolysans/morbillorum		1
		Gemella sanguinis		1
		Staphylococcus aureus		1
		Staphylococcus epidermidis		3
		Staphylococcus hominis		1
		Staphylococcus warneri		1
	Streptococcaceae	Streptococcus anginosus	2	2
		Streptococcus constellatus	5	1
		Streptococcus dysgalactiae		1
		Streptococcus gordonii		2
		Streptococcus intermedius	3	1
		Streptococcus intermedius/anginosus	2
		Streptococcus mitis			1
		Streptococcus mutans		2
		Streptococcus oralis		5	1
		Streptococcus parasanguinis	4	12
		Streptococcus peroris	1	4
		Streptococcus pneumoniae	4	12
		Streptococcus pyogenes	6	4
		Streptococcus salivarius	1	6
		Streptococcus sanguinis	1	2
		Streptococcus sobrinus		1
	Veillonellaceae*	Dialister pneumosintes	1
		Veillonella atypica	1
Actinobacteria	Actinomycetaceae	Actinomyces radicidentis	1
		Actinomyces naeslundii		1
		Actinomyces odontolyticus	1	5
		Actinomyces oris		3
	Corynebacteriaceae	Corynebacterium argentoratense	1	2
	Bifidobacteriaceae*	Alloscardovia omnicolens		2
		Bifidobacterium dentium	1	1
	Micrococcaceae	Rothia dentocariosa	2	1
		Rothia mucilaginosa		7
		Kocuria marina		1
		Micrococcus luteus		1
Bacteroidetes	Bacteroidaceae*	Bacteroides pyogenes		1
	Prevotellaceae*	Prevotella intermedia		1
		Prevotella melaninogenica	1	2
Fusobacteria	Fusobacteriaceae*	Fusobacterium necrophorum	1	2
		Fusobacterium nucleatum	3

*Anaerobes.

Fig. 2 Patients with positive pus samples and their microbiological results with locations.

Table 3 Antibiotic susceptibility of opportunistic bacteria

	Pus			Biopsy			Total
	S (%)	I (%)	R (%)	S (%)	I (%)	R (%)	S (%)	I (%)	R (%)
Streptococcus parasanguinis
P	1 (25)	3 (75)	0 (0)	7 (70)	3 (30)	0 (0)	7 (50)	5 (36)	0 (0)
SAM	1 (25)	3 (75)	0 (0)	6 (60)	2 (20)	2 (20)	7 (50)	5 (36)	2 (14)
CD	4 (100)	0 (0)	0 (0)	8 (80)	0 (0)	2 (20)	12 (86)	0 (0)	2 (14)
Streptococcus pneumoniae
P	3 (100)	0 (0)	0 (0)	1 (13)	7 (88)	0 (0)	4 (36)	7 (64)	0 (0)
CXM	3 (100)	0 (0)	0 (0)	3 (38)	2 (25)	3 (38)	6 (55)	2 (18)	3 (27)
SAM	3 (100)	0 (0)	0 (0)	7 (88)	1 (13)	0 (0)	10 (91)	1 (9)	0 (0)
CD	3 (100)	0 (0)	0 (0)	8 (100)	0 (0)	0 (0)	11 (100)	0 (0)	0 (0)
E	3 (100)	0 (0)	0 (0)	1 (13)	0 (0)	7 (88)	4 (36)	0 (0)	7 (64)
CIP	0 (0)	0 (0)	3 (100)	0 (0)	2 (25)	6 (75)	0 (0)	2 (18)	9 (82)
Streptococcus pyogenes
P	6 (100)	0 (0)	0 (0)	4 (100)	0 (0)	0 (0)	10 (100)	0 (0)	0 (0)
CXM	6 (100)	0 (0)	0 (0)	3 (75)	0 (0)	1 (25)	9 (100)	0 (0)	1 (10)
SAM	6 (100)	0 (0)	0 (0)	3 (75)	0 (0)	1 (25)	9 (100)	0 (0)	1 (10)
CD	6 (100)	0 (0)	0 (0)	3 (75)	0 (0)	1 (25)	9 (100)	0 (0)	1 (10)
E	5 (83)	0 (0)	1 (17)	2 (50)	1 (25)	1 (25)	7 (70)	1 (10)	2 (20)
Streptococcus milleri group
P	7 (100)	0 (0)	0 (0)	3 (100)	0 (0)	0 (0)	10 (100)	0 (0)	0 (0)
SAM	7 (100)	0 (0)	0 (0)	3 (100)	0 (0)	0 (0)	10 (100)	0 (0)	0 (0)
CD	7 (100)	0 (0)	0 (0)	3 (100)	0 (0)	0 (0)	10 (100)	0 (0)	0 (0)
Fusobacterium necrophorum
P	1 (100)	0 (0)	0 (0)	0 (0)	0 (0)	3 (100)	1 (25)	0 (0)	3 (75)
SAM	1 (100)	0 (0)	0 (0)	0 (0)	0 (0)	3 (100)	1 (25)	0 (0)	3 (75)
CD	1 (100)	0 (0)	0 (0)	1 (100)	0 (0)	0 (0)	2 (100)	0 (0)	0 (0)
MTZ	1 (100)	0 (0)	0 (0)	1 (100)	0 (0)	0 (0)	2 (100)	0 (0)	0 (0)

S, susceptible; R, resistant; I, intermediate; P, penicillin; SAM, ampicillin/sulbactam; CXM, cefuroxime; CD, clindamycin; E, erythromycin; CIP, ciprofloxacin; MTZ, metronidazole.

We also determined the minimum inhibitory concentration (MIC) values for R. mucilaginosa: 0.016 and 0.125 for penicillin; 0.047, 0.094, 0.5, and 0.38 for cefuroxime; and 0.75, 2, and 6.2 for ciprofloxacin. These data were not included in the table since no MIC cut-off values exist for R. mucilaginosa susceptibility and resistance.