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Tympanocentesis results of a Canadian pediatric myringotomy population, 2008 to 2010
Maria K Brake1, Kyle Jewer, Gordon Flowerdew
1IWK Health Centre, Division of Otolaryngology, Department of Surgery, Dalhousie University, Halifax, NS.
Objective:
This study was completed to evaluate the middle ear microbiology of a pediatric population with chronic otitis media with effusion and to determine if there has been a change in the spectrum of microorganisms or their antibiotic susceptibility in the modern age of antibiotic therapy.
Design:
Retrospective chart review.
Setting:
A Canadian academic pediatric otolaryngology practice.
Methods:
This study includes all consecutive patients under the care of one pediatric otolaryngologist undergoing myringotomy and tube placement between the dates of September 2008 and August 2010. Tympanocentesis was performed on each middle ear immediately following the myringotomy, and the specimen was sent for microbiologic analysis.
Main Outcome Measures:
Culture results and sensitivities were compared to previous similar studies.
Results:
A total of 246 children (average age of 4 ± 3 years) and 506 ears had culture results as follows: normal flora, 47%; no growth, 35%; Haemophilus influenzae, 9%; Streptococcus pneumoniae, 4%; Moraxella catarrhalis, 3%; and Staphylococcus aureus, 2%. Ten of the 11 S. aureus cultures were methicillin resistant. The rate of pathogenicity decreased from 36.5% in children aged < 4 years to 15.3% in children aged 4+ years (p = .001).
Conclusion:
H. influenzae continues to lead as the most common pathogen; however, S. aureus is increasing in frequency. Pathogenicity decreases with age and appears to be lower in children with a cleft palate.
