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Microbiology of otitis media in the Paris, France, area from 1987 to 1997
P Gehanno1, A Panajotopoulos, B Barry
1Service ORL, Hĵpital Bichat-Claude Bernard, Paris, France. pierre.gehanno@bch.ap-hop-paris.fr
Insights
Epidemiologic trends in pediatric acute otitis media reveal a significant rise in antimicrobial resistance. Frequent studies are crucial to monitor and address the increasing prevalence of resistant bacterial strains.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Acute otitis media (AOM) is a common pediatric infection.
- Understanding causative pathogens and their resistance patterns is vital for effective treatment.
- Long-term surveillance is necessary to track evolving resistance trends.
Purpose of the Study:
- To investigate the 10-year epidemiologic trends in the bacteriology of pediatric acute otitis media.
- To analyze changes in the susceptibility of common AOM pathogens to antibiotics over time.
Main Methods:
- Prospective collection of bacterial samples from 2149 children (3-36 months) with AOM over a decade.
- Standardized methods for sample collection (tympanocentesis or spontaneous otorrhea), transport, and culture.
- Identification of bacterial pathogens and assessment of antimicrobial susceptibility.
Main Results:
- Pathogens were isolated from 70% of patients, with Haemophilus influenzae (40%) and Streptococcus pneumoniae (31%) being most common.
- A significant increase in beta-lactamase-producing H. influenzae was observed, rising from 20% (1987-1989) to 70% (last 2 years).
- Penicillin-resistant S. pneumoniae rates increased dramatically from 7% (1987) to 70% (1996-1997).
Conclusions:
- A rapid and substantial rise in antimicrobial-resistant bacterial strains causing pediatric AOM was documented.
- The findings underscore the urgent need for continuous epidemiologic surveillance of AOM pathogens.
- This data highlights the challenge of treating AOM due to increasing antibiotic resistance.
Purpose Of The Study:
To investigate epidemiologic trends in the bacteriology of acute otitis media, data were recorded during a 10-year period by the same group of investigators during clinical studies in pediatric outpatients.
Methods:
Bacterial samples were obtained before antibiotic treatment from 2149 children (age 3 to 36 months) with acute otitis media. All samples were transported, handled and cultured in the same way throughout the 10-year period.
Results:
From the study patients 1862 samples of middle ear secretion were collected by tympanocentesis and 287 samples were collected from spontaneous otorrhea occurring within 24 h. Pathogens were isolated from 70% of patients. Pathogens included Haemophilus influenzae (40%), Streptococcus pneumoniae (31%) and Moraxella catarrhalis (8%). The incidence of beta-lactamase-producing H. influenzae was approximately 20% from 1987 to 1989, was approximately 35% from 1990 to 1995 and increased to 60 and 70% during the last 2 years. The rate of S. pneumoniae with decreased susceptibility to penicillin gradually increased from 7% in 1987 to 70% in 1996 and 1997.
Conclusion:
The very high incidence of antimicrobial resistant strains reached during a short period in pediatric acute otitis media in our area, emphasizes the need for frequent epidemiologic studies.
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