Objectives

The objectives of this study were to identify biofilm producing Staphylococci causing chronic tonsillitis, to extract Citrus limon and Cinnamon cassia essential oils and to study their antimicrobial and antibiofilm properties.

Patients and Methods

Tonsillar biopsies were collected from 163 chronic tonsillitis patients undergoing tonsillectomy at the Otorhinolaryngology & Head and Neck Surgery Department, Faculty of Medicine, Assiut University. The isolates were microbiologically identified, and theantimicrobial sensitivity pattern was determined. Extraction of essential oils(EOs) fromfresh citrus limon fruits peel (CEO) and dry Cinnamon cassia(CCEO) was doneby Hydro distillation and were characterized by Gas Chromatography-Mass Spectrometry. The MIC, MBC, MBEC and MBICof the extracted oils were determined. Scanning Electron Microscopy (SEM) analysis was done before and aftertreatment with EOs and vancomycin.

Results

Bacteria were isolated from 75 tonsillar specimens, giving a total percent of 46.01% (75/163). Biofilm producing Staphylococcus aureus was the most common organism (77.3 %, 58/75). The highest antimicrobial sensitivity was for vancomycin (90.6%) and erythromycin (81.3%). For CEO, the MIC, MBC, MBIC and MBEC values ranged from 0.25 to 4% v/v, while for CCEO( 0.625 to 10% v/v). By SEM analysis, damage of S. aureus cells occurred by the effect of EOs and vancomycin. The major components of CEOwere alpha-limonene (10.9%) and beta-I-pinene (10.7 %), while forCCEO, it was trans-cinnamic aldehyde (71%).

Conclusions

Biofilm producing S. aureus is the most common bacteria causing chronic tonsillitis.CEO and CCEO could havea potential prophylactic and therapeutic use against biofilm producing Staphylococci causing chronic tonsillitis.