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[Nasopharyngeal and middle ear flora in children with acute otitis media]

Beata Zielnik-Jurkiewicz1, Magdalena Kolczyńska

  • 1Szpital Dzieciecy, Oddział Otolaryngologiczny SZPZOZ im. prof. J. Bogdanowicza w Warszawie.

Otolaryngologia Polska = the Polish Otolaryngology
|November 9, 2005
PubMed

Insights

Nasopharyngeal flora in children with acute otitis media (AOM) mirrors middle ear pathogens. Susceptibility testing of nasopharyngeal bacteria can guide empirical antibiotic treatment for AOM, improving outcomes.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology
  • Antimicrobial resistance

Background:

  • The nasopharynx serves as a reservoir for bacteria implicated in acute otitis media (AOM) in children.
  • Understanding the microbial landscape and antibiotic susceptibility patterns in both the nasopharynx and middle ear is crucial for effective AOM management.

Purpose of the Study:

  • To identify the microorganisms present in the nasopharynx and middle ear of children diagnosed with acute otitis media.
  • To determine the antimicrobial susceptibility profiles of these isolated pathogens.

Main Methods:

  • Samples were collected concurrently from the nasopharynx and middle ear of 128 children (1-14 years) with purulent AOM.
  • Bacterial isolation was performed using standard agar, chocolate, and blood plates, followed by incubation and examination.
  • Antimicrobial susceptibility testing was conducted using the disk diffusion method against a panel of 10 antibiotics.

Main Results:

  • The most frequent bacteria isolated were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, comprising over 75% of isolates from both sites.
  • Moraxella catarrhalis showed a statistically significant increase in middle ear samples compared to nasopharyngeal samples (p < 0.01).
  • High susceptibility rates were observed for amoxicillin/clavulanate (over 80%), while resistance was prominent against trimethoprim/sulfamethoxazole (over 60%) and penicillin (over 25%).

Conclusions:

  • The microbial flora of the nasopharynx and middle ear in children with AOM are similar.
  • Nasopharyngeal bacterial susceptibility data can be a reliable indicator for guiding empirical antibiotic therapy in pediatric AOM cases.
  • The study highlights significant resistance to common antibiotics like trimethoprim/sulfamethoxazole and penicillin.

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