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Updated: Aug 11, 2026

Characterization of Inflammatory Responses During Intranasal Colonization with Streptococcus pneumoniae
Published on: January 17, 2014
Impact of resistant pneumococcus on rates of acute mastoiditis
P J Antonelli1, N Dhanani, C M Giannoni
1Department of Otolaryngology, University of Florida College of Medicine,Gainesville 32610, USA.
Objective:
To determine whether the rate of acute mastoiditis is rising, specifically as a result of antibiotic-resistant strains of Streptococcus pneumoniae.
Methods:
A retrospective chart review of all patients with a discharge diagnosis of acute mastoiditis between July 1, 1987, and June 30, 1997, was performed at our academic, tertiary-care medical center. There were no interventions, and the main outcome measures included the number of cases of acute or coalescent mastoiditis, stratified by pathogen, per year.
Results:
The rate of acute mastoiditis as a proportion of yearly otorhinolaryngology admissions increased linearly over time (P = 0. 024). Pneumococcal-related rates of acute mastoiditis, expressed as a proportion of yearly hospital and otorhinolaryngology admissions, increased linearly over time (P = 0.002, P = 0.002). All but 1 case of pneumococcal mastoiditis during the past 3 years were caused by penicillin-resistant strains.
Conclusions:
The emergence of antibiotic-resistant S pneumoniae may be responsible for an increasing rate of acute mastoiditis.
Insights
The rate of acute mastoiditis is increasing, potentially due to antibiotic-resistant Streptococcus pneumoniae. This study highlights a concerning trend in pediatric ear infections.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Pediatrics
Background:
- Acute mastoiditis is a serious complication of middle ear infections.
- The rise of antibiotic-resistant bacteria poses a significant threat to public health.
- Understanding trends in mastoiditis is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the trend of acute mastoiditis incidence.
- To determine if antibiotic-resistant Streptococcus pneumoniae contributes to this trend.
Main Methods:
- Retrospective chart review of acute mastoiditis cases from 1987-1997.
- Analysis of case numbers stratified by pathogen and year.
- Comparison of mastoiditis rates against yearly otorhinolaryngology admissions.
Main Results:
- A linear increase in acute mastoiditis rates was observed over the study period.
- Pneumococcal-related mastoiditis rates also showed a significant linear increase.
- Penicillin-resistant Streptococcus pneumoniae caused most pneumococcal mastoiditis cases in recent years.
Conclusions:
- Antibiotic-resistant Streptococcus pneumoniae is a likely factor in the rising incidence of acute mastoiditis.
- This finding underscores the need for vigilant monitoring and updated treatment guidelines.
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