Microbiocenosis in patients with acute tonsillitis influenced by smoking

Acute tonsillitis is a widespread disease, the course of which can be affected by the patient’s smoking status, which leads to changes in the oropharyngeal microbiota. The purpose of the study was to evaluate the effect of smoking on the development of palatine tonsil microbiocenosis in patients with acute tonsillitis. The study included 54 patients who were divided into two groups: smokers (n = 26) and non-smokers (n = 28). The microbiological study included inoculating samples on various nutrient media, followed by identification of microorganisms by phenotypic methods. Microbiota density was estimated by counting colony-forming units. The Mann-Whitney U-test, Fisher’s exact test, and principal component analysis were used for statistical analysis. Principal component analysis did not reveal a clear clustering of the samples, which indicated that there were no global changes in the tonsil microbiota depending on smoking status. However, selective shifts were found, and these included a significantly reduced colonisation density of Corynebacterium spp. (p = 0.04) and the exclusive presence of fungi of the genus Candida among smokers. Clinically, the groups did not differ in the severity of the disease on the Centor scale, but smokers were more likely to receive antibiotic therapy (30.8% and 10.7%) and had a higher incidence of respiratory infections (42.3% and 27.3%). The results showed that smoking does not change the overall structure of the tonsil microbiota in acute tonsillitis, but causes selective dysbiosis. This substantiated the need to consider the patient’s smoking status to assess the risk of recurrent infection and develop more personalised approaches to prescribing antibiotic therapy