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Published on: February 23, 2014
Pathogens causing recurrent and difficult-to-treat acute otitis media, 2003-2006
Michael E Pichichero1, Janet R Casey, Alejandro Hoberman
1University of Rochester Medical Center and Legacy Pediatrics, Rochester, New York 14642, USA. michael_pichichero@urmc.rochester.edu
Clinical Pediatrics
|June 19, 2008
Summary
The heptavalent pneumococcal conjugate vaccine (PCV7) impacted acute otitis media (AOM) microbiology. While Haemophilus influenzae remains common, penicillin-nonsusceptible Streptococcus pneumoniae are reemerging in AOM treatment failure and recurrent AOM cases.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Microbiology
Background:
- The heptavalent pneumococcal conjugate vaccine (PCV7) has been widely used since 2000.
- Recurrent acute otitis media (AOM) and AOM treatment failure (AOMTF) remain significant pediatric challenges.
- Understanding the evolving microbiology of AOM is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the microbiological landscape of recurrent AOM and AOMTF following widespread PCV7 implementation.
- To compare the prevalence of key bacterial pathogens and their antimicrobial resistance patterns over three respiratory seasons.
Main Methods:
- Retrospective cohort study analyzing 244 AOM isolates from tympanocentesis.
- Isolates were collected from geographically diverse pediatric populations during 2003-2006.
- Microbiological analysis included pathogen identification and antimicrobial susceptibility testing.
Main Results:
- Haemophilus influenzae was the most frequently isolated pathogen in AOMTF and recurrent AOM cases.
- The proportion of Streptococcus pneumoniae isolates showed an increasing trend (35% to 46%) over the study period.
- Penicillin-nonsusceptible S. pneumoniae (PNSP) and beta-lactamase-producing H. influenzae remained prevalent.
Conclusions:
- Despite PCV7 use, H. influenzae continues to be a primary pathogen in complicated AOM.
- Penicillin-nonsusceptible S. pneumoniae are reemerging as significant contributors to recurrent AOM and treatment failure.
- Ongoing surveillance of AOM microbiology and resistance patterns is essential.
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