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Pneumococcal acute otitis media in children
G Kouppari1, A Zaphiropoulou, G Stamos
1Microbiology Laboratory, Medical School, University of Athens, M. Asias 75, Goudi, Athens 11527, Greece.
Insights
Penicillin resistance in Streptococcus pneumoniae causing childhood otitis media was 15.9%. Multiresistant strains, often linked to specific serogroups, highlight the need for ongoing surveillance of antibiotic resistance in acute otitis media.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Streptococcus pneumoniae is a leading bacterial cause of AOM.
- Antibiotic resistance in S. pneumoniae poses a significant public health challenge.
Purpose of the Study:
- To assess the prevalence of penicillin resistance in Streptococcus pneumoniae isolates from children with AOM.
- To identify the antibiotic susceptibility patterns and serogroups of these isolates.
- To evaluate the clinical and laboratory findings associated with S. pneumoniae AOM.
Main Methods:
- Prospective study of 113 children with S. pneumoniae AOM from October 1995 to September 1996.
- Antibiotic susceptibility testing using Kirby-Bauer and E-test methods.
- Serotyping of isolates performed via Quellung reaction.
Main Results:
- 15.9% of S. pneumoniae isolates showed penicillin insensitivity (4.4% highly resistant, 11.5% intermediate resistance).
- 22.1% of isolates were resistant to one or more antibiotics; multiresistant strains were more common in penicillin-resistant isolates.
- Predominant serogroups among penicillin-insensitive isolates included 19, 9, 23, 6, and 14.
Conclusions:
- A significant proportion of S. pneumoniae causing AOM in children exhibited penicillin resistance.
- Multiresistant S. pneumoniae isolates were frequently associated with specific serogroups (19, 9, 6, 23).
- These findings underscore the importance of monitoring antibiotic resistance trends in pediatric AOM pathogens.
Objectives:
To evaluate the clinical and laboratory findings of Streptococcus pneumoniae acute otitis media in children during a 1 year period.
Methods:
From October 1995 to September 1996, 113 children aged 2 months to 14 years (median 18 months), with S. pneumoniae acute otitis media were studied. Susceptibility testing was performed by the Kirby-Bauer method and the E-test, and serotyping by the Quellung reaction.
Results:
E-test assays detected five isolates (4.4%) to be highly resistant to penicillin and 13 (11.5%) that had intermediate resistance. All isolates were found to be susceptible to vancomycin, rifampicin and cefotaxime. In total, 25 isolates (22.1%) were resistant to one or more drugs. Fifty per cent of the penicillin-resistant or intermediately resistant S. pneumoniae isolates were resistant to multiple drugs, whereas only 2.1% of the penicillin-susceptible isolates were resistant to multiple drugs. The predominating serogroups of the isolates with reduced susceptibility to penicillin were the 19 (61.1%), 9 (16.7%), 23 (11.1%), 6 (5.5%) and 14 (5.5%) whereas those of the susceptible isolates were the 19 (26.3%), 14 (13.7%), 3 (11.6%), 6 (11.6%), 9 (8.4%), 1 (5.3%) and 12 (5.3%).
Conclusions:
Streptococcus pneumoniae isolates from children with acute otitis media were penicillin-insensitive in 15.9%. The multiresistant S. pneumoniae isolates belonged to serogroups: 19 (45.4%), 9 (27.3%), 6 (18.2%) and 23 (9.1%).