DIAGNOSTIC APPROACHES AND CLINICAL ASPECTS OF THE IMPACT OF STAPHYLOCOCCAL PERSISTENCE ON THE ETIOLOGY OF ACUTE TONSILLITIS

Abstract

Introduction. Tonsillitis is one of the most common upper respiratory tract diseases in both adults and children.Bacteriological studies of throat swabs from patients with acute tonsillitis reveal polymicrobial associations, including Streptococcus pyogenes, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae. Group A streptococcus remains the primary bacterial pathogen; however, most cases of acute tonsillitis are viral in origin. Identifying the etiological agent is crucial for selecting an optimal treatment strategy.The Aim of the Study – to investigate the role of S. aureus colonization in the etiology of tonsillitis and assess its prevalence among patients with bacterial and viral infections of the oropharynx.Research Methods. A total of 52 patients with tonsillitis symptoms who visited a primary healthcare center were examined. The patients’ ages ranged from 18 to 57 years (median – 24). The diagnosis was established following a standardized clinical protocol. Pathogen identification was performed using rapid antigen tests and bacteriological culture. Patients were divided into two groups: Group 1 (n = 37) – without S. aureus detection, and Group 2 (n = 15) – with S. aureus presence.Results and Discussion. A positive streptococcal test was found in 9.61% of patients, viral infections in 65.38%, and negative results in 20.01%. Bacteriological analysis confirmed S. aureus in 28.8% of cases. S. aureus was more frequently detected in patients without an identified pathogen (OR = 2.86; 95% CI: 0.76–10.70).Strep_A was detected more frequently in patients with S. aureus (13.3% vs. 8.1%), though the difference was not statistically significant (OR = 1.74; 95% CI: 0.26–11.66).Conclusions. S. aureus was more frequently found in patients without a confirmed bacterial or viral pathogen, suggesting a potential role in the pathogenesis of tonsillitis. Viral co-infections, particularly adenovirus and RSV, were associated with lower S. aureus detection rates.