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Resistant Streptococcus pneumoniae strains in children with acute otitis media- high risk of persistent colonization

Izabela Korona-Glowniak1, Piotr Zychowski2, Radoslaw Siwiec3

  • 1Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics, Medical University of Lublin, Chodzki 1 Street, 20-093, Lublin, Poland. iza.glowniak@umlub.pl.

BMC Infectious Diseases
|September 27, 2018
PubMed

Insights

Persistent Streptococcus pneumoniae in children with acute otitis media (AOM) is linked to recurrent infections. Antibiotic-resistant strains in the nasopharynx/oropharynx may predispose children to recurring AOM, even after treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Vaccinology

Background:

  • Acute otitis media (AOM) remains common in children despite pneumococcal conjugate vaccines.
  • Streptococcus pneumoniae is a primary cause of AOM, with nasopharyngeal carriage potentially leading to recurrent infections.

Purpose of the Study:

  • To investigate the relationship between nasopharyngeal/oropharyngeal (NP/OP) and middle ear fluid (MEF) Streptococcus pneumoniae strains in children with AOM.
  • To analyze phenotypic and genotypic characteristics of these strains, including serotype, antibiotic susceptibility, and multilocus sequence typing.

Main Methods:

  • Collected NP/OP and MEF samples from 62 children (1-16 years) with AOM.
  • Performed serotyping, antibiotic susceptibility testing, and multilocus sequence typing on 55 S. pneumoniae strains.
  • Utilized statistical analysis, including multivariate analysis, to assess associations.

Main Results:

  • S. pneumoniae was found in 27.4% of MEF samples and 43.6% of positive bacterial MEF samples.
  • A significant concordance (p < 0.0001) was observed between MEF isolation and NP/OP colonization.
  • 84% of strains exhibited multidrug resistance, and vaccine-serotype strains were highly prevalent (84-92%).

Conclusions:

  • Persistent, antibiotic-resistant S. pneumoniae strains in children with AOM after failed eradication are likely predisposing factors for infection recurrence.
  • Nasopharyngeal colonization post-antibiotic therapy is associated with shorter treatment duration in bilateral AOM.
Abstract

Keywords:
Acute otitis mediaAntibiotic resistanceMLSTRisk factorsStreptococcus pneumoniae

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