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Reappearance of group A streptococci in acute otitis media
1Department of Clinical Microbiology, Aalborg Hospital, Denmark.
Abstract:
Specimens from acute otitis media (AOM) examined in the first quarter of the years 1986, 1987, 1988, and 1989 were reviewed in order to point out any changes in the bacteriological etiology. A total of 1,722 specimens were taken in the community and in the hospitals of a county of 500,000 inhabitants in the 4-year-period: 447 (1986), 420 (1987), 388 (1988), 467 (1988). The majority of the specimens came from children less than 10 years of age. The specimen sampling technique differed between the various otologists, but their sampling techniques were constant through the years. Haemophilus influenzae was the most frequent isolate and held a constant incidence of 29.9% with little variation. In 1986-88 Streptococcus pneumoniae was the second (19.8%) and group A streptococci (GAS) the third (9.8%) most common agent in frequency. In 1989 a change in the etiologic agents was seen as GAS increased in frequency to 18.8% (p less than 0.001), while no significant changes occurred in the frequency of H. influenzae and S. pneumoniae. 33% of the specimens were negative in the whole period. It is too early to decide whether a transient epidemic has occurred or whether the findings announce a more constant change in etiology.
Insights
Bacterial causes of acute otitis media (AOM) were studied over four years. Group A streptococci (GAS) significantly increased in 1989, suggesting a potential shift in AOM etiology.
Area of Science:
- Microbiology
- Pediatrics
- Infectious Diseases
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Understanding the bacterial causes of AOM is crucial for effective treatment.
- Etiological patterns of AOM may change over time.
Purpose of the Study:
- To analyze changes in the bacteriological etiology of acute otitis media (AOM) over a four-year period.
- To identify shifts in the prevalence of common bacterial pathogens responsible for AOM.
Main Methods:
- Retrospective review of 1,722 AOM specimens collected between 1986 and 1989.
- Analysis of bacterial isolates from community and hospital settings.
- Comparison of pathogen frequencies across the four-year study period.
Main Results:
- Haemophilus influenzae was the most frequent isolate (29.9%) with stable incidence.
- Streptococcus pneumoniae and group A streptococci (GAS) were the second and third most common pathogens in 1986-88.
- In 1989, GAS significantly increased to 18.8% (p<0.001), while H. influenzae and S. pneumoniae remained stable.
- 33% of specimens were culture-negative throughout the study period.
Conclusions:
- A notable increase in group A streptococci (GAS) as a cause of acute otitis media (AOM) was observed in 1989.
- This shift may indicate a changing etiological landscape for AOM.
- Further monitoring is needed to determine if this represents a transient epidemic or a sustained change in AOM pathogens.