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Streptococcus pneumoniae colonization in the young child: association with otitis media and resistance to penicillin

M K Zenni1, S H Cheatham, J M Thompson

  • 1Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

The Journal of Pediatrics
|October 1, 1995
PubMed

Insights

Penicillin-resistant Streptococcus pneumoniae colonization is common in young children and linked to acute otitis media. Resistance also correlates with unresolved ear infections, highlighting a public health concern.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Streptococcus pneumoniae (S. pneumoniae) is a common cause of childhood infections.
  • Antibiotic resistance in S. pneumoniae is a growing global health challenge.
  • Nasopharyngeal colonization is a key factor in the transmission and pathogenesis of pneumococcal infections, including otitis media.

Purpose of the Study:

  • To determine the prevalence of nasopharyngeal colonization by penicillin-susceptible and penicillin-resistant Streptococcus pneumoniae in young children.
  • To investigate the association between S. pneumoniae colonization and the incidence of otitis media (OM).
  • To assess the impact of penicillin resistance on OM outcomes.

Main Methods:

  • An observational study was conducted involving 215 children under 6 years old.
  • Nasopharyngeal cultures were collected and analyzed for S. pneumoniae.
  • Susceptibility testing was performed using microdilution to determine penicillin resistance.

Main Results:

  • 44% of nasopharyngeal cultures were positive for S. pneumoniae.
  • 37% of S. pneumoniae isolates exhibited intermediate or high resistance to penicillin.
  • Nasopharyngeal colonization was significantly associated with acute otitis media (p = 0.0002).
  • Penicillin-resistant isolates were more frequent in children younger than 2 years.
  • Unresolved otitis media was more common in children colonized with resistant strains (p = 0.04).

Conclusions:

  • High rates of nasopharyngeal carriage of penicillin-resistant S. pneumoniae were observed in young children.
  • Pneumococcal colonization is linked to an increased incidence of acute otitis media.
  • Penicillin resistance in colonizing strains is associated with a higher incidence of unresolved otitis media.
Abstract

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