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Abstract: Interactions between micro-organisms that include antagonism (interference) and synergism maintain balance between members of the normal endogenous flora, and play a role in preventing colonization by potential pathogens. Bacteria with interference capability of potential respiratory tract pathogens include alpha-hemolytic streptococci, non-hemolytic streptococci, Prevotella spp. and Peptostreptococcus spp. The role of bacterial interference in the occurrence of upper respiratory tract infections and its effect on their eradication is discussed. The infections include otitis media, sinusitis and pharyngo-tonsillitis. Treatment with antimicrobial agents and direct and indirect exposure to smoking, can affect the balance between the interfering organisms and potential pathogens. Introduction into the indigenous microflora of low virulence bacterial strains that are capable of interfering with colonization and infection with virulent organisms has been used to prevent the failure of antimicrobials in the treatment of pharyngo-tonsillitis and otitis media. [Copyright &y& Elsevier]

Abstract: Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck. This review summarizes the aerobic and anaerobic microbiology and antimicrobials therapy of these infections. These include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre Syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. [Copyright &y& Elsevier]

Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck in children. This review summarizes the aerobic and anaerobic microbiology and antimicrobial therapy of acute and chronic upper respiratory tract infection and other head and neck infections. These infections include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. [ABSTRACT FROM AUTHOR]

Abstract: The normal oropharyngeal flora contained aerobic and anaerobic bacteria that can cause respiratory infections including sinusitis. Some of these bacteria can interfere with the growth of potential pathogens and may play a role in preventing infections. Anaerobic bacteria emerge as pathogens as the infection becomes chronic. This may be the result of the selective pressure of antimicrobial agents that enable resistant anaerobic organisms to survive, and from the development over time of conditions appropriate for anaerobic growth, which include the reduction in oxygen tension and an increase in acidity within the sinus cavity. Anaerobes were isolated in acute maxillary sinusitis of odontogenic origin and in over half of the patients with chronic sinusitis whenever proper techniques for their cultivation were employed. These organisms were also recovered in acute sinusitis that was associated with dental infections. The predominant isolates were pigmented Prevotella and Porphyromonas, Fusobacterium and Peptostreptococcus spp. [Copyright &y& Elsevier]

Abstract: Mastoiditis (M) is the most common intratemporal complication of otitis media. The incidence of M has decreased since the advent of antimicrobial agents. In the last decade, however, there has been a marked increased in the incidence of acute M in several communities, sometimes in association with the growing resistance of pneumococci. Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus and Haemophillus influenzae are the most common organisms recovered in acute M. Several recent studies demonstrated the predominance of Pseudomonas aeruginosa in this infection. However, because P. aeruginosa colonizes the ear canal it can contaminate specimens obtained through the non-sterile ear canal. P. aeruginosa, Enterobacteriaceae, S. aureus and anaerobic bacteria are the most common isolates in chronic M. Anaerobes predominate in studies where adequate methods for their isolation are employed. Management of uncomplicated M requires the administration of parenteral antimicrobial therapy and myringotomy with or without tympanostomy tube placement. If no improvement occurs within 48h, surgical intervention and drainage may be necessary. The procedure generally employed is simple mastoidectomy, and tympanostomy tube placement. Radical mastoidectomy is performed only if there is no improvement after simple mastoidectomy. [Copyright &y& Elsevier]