Related Experiment Videos
Bacteriological features and chemotherapy of adult acute purulent otitis media
Abstract:
Eighty-eight patients from 16 to 79 years old, with acute purulent otitis media, were bacteriologically examined at the Otorhinolaryngology Department of a primary care hospital in Tokyo from July 1979 to May 1983. Fifty-six patients underwent paracentesis, and 32 patients exhibited otorrhea due to previous spontaneous perforation of the tympanic membrane. Bacteriologic cultures revealed the presence of Streptococcus pneumoniae (62.5 per cent), including S. pneumoniae Type III (28.1 per cent), Haemophilus influenzae (10.5 per cent), Staphylococcus aureus (11.5 per cent), and Streptococcus pyogenes (7.3 per cent). S. pneumoniae Type III had a notably high detection rate in patients from 50 to 79 years old (50-75 per cent). Because Haemophilus influenzae was detected at a relatively high rate in patients of all ages, if can be considered as a major causative pathogen of AOM. In 44 patients, selected mainly from those who underwent paracentesis, a comparative study of bacteria found in middle ear fluid and naso-pharyngeal mucus revealed the same bacteria in 43 out of 44 cases (97.7 per cent), indicating the presence of bacterial infection through the auditory canal. Antibiotics were selected according to an Expected Efficacy Index (EEI), the antibiotic of first choice being Ampicillin or Cefaclor.
Insights
This study identified key bacteria causing acute purulent otitis media, with Streptococcus pneumoniae being most common. Findings guide antibiotic selection for effective treatment.
Area of Science:
- Otolaryngology
- Microbiology
- Infectious Diseases
Background:
- Acute purulent otitis media (AOM) is a common infection requiring prompt diagnosis and treatment.
- Bacteriological examination is crucial for identifying causative pathogens and guiding antimicrobial therapy.
- Previous studies have indicated various bacterial agents responsible for AOM, necessitating ongoing surveillance.
Purpose of the Study:
- To conduct a comprehensive bacteriological examination of patients with acute purulent otitis media.
- To identify the predominant bacterial pathogens involved in AOM in a primary care setting.
- To evaluate the relationship between middle ear fluid and nasopharyngeal flora in AOM patients.
Main Methods:
- Bacteriological cultures were performed on middle ear fluid and nasopharyngeal swabs from 88 patients diagnosed with AOM.
- Patients included those undergoing paracentesis and those with otorrhea from spontaneous tympanic membrane perforation.
- A comparative analysis of bacterial findings in middle ear fluid and nasopharyngeal mucus was conducted in a subset of patients.
Main Results:
- Streptococcus pneumoniae was the most frequently isolated pathogen (62.5%), including S. pneumoniae Type III (28.1%).
- Haemophilus influenzae (10.5%), Staphylococcus aureus (11.5%), and Streptococcus pyogenes (7.3%) were also identified.
- S. pneumoniae Type III showed a high prevalence in older adults (50-79 years).
- A high concordance (97.7%) was observed between bacteria in middle ear fluid and nasopharyngeal mucus, suggesting auditory canal infection.
- Ampicillin or Cefaclor were recommended as first-choice antibiotics based on the Expected Efficacy Index (EEI).
Conclusions:
- Streptococcus pneumoniae and Haemophilus influenzae are significant causative agents of acute purulent otitis media.
- The nasopharynx serves as a reservoir for pathogens causing middle ear infections.
- Empirical antibiotic selection, such as Ampicillin or Cefaclor, is supported by the identified pathogens and their susceptibility patterns.