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[Bacteriological study in acute otitis media]

M Le Bideau1, A Mouzard, C Chamoux

  • 1Clinique médicale pédiatrique, centre hospitalier regional universitaire, Nantes, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|March 1, 1997
PubMed
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Bacteriological studies in acute otitis media show that middle ear aspirates are often sterile after antibiotic treatment, suggesting other factors may cause persistent symptoms. Penicillin-resistant Streptococcus pneumoniae strains were identified but rarely caused clinical failure.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology of otitis media

Background:

  • Acute otitis media (AOM) is a common childhood infection.
  • Bacteriological epidemiology of AOM requires ongoing investigation.

Purpose of the Study:

  • To investigate the bacteriological epidemiology of acute otitis media in children.
  • To assess the impact of prior antibiotic treatment on middle ear cultures.

Main Methods:

  • Prospective study in a pediatric hospital emergency service.
  • Inclusion of 158 children aged 6 months to 6 years with AOM.
  • Tympanocentesis and middle ear fluid culture performed in 118 children, with 46 having prior antibiotic exposure.

Main Results:

  • Middle ear aspirates were sterile in 35% of untreated children and 64% of those previously treated with antibiotics.

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  • Predominant bacteria identified were Haemophilus influenzae and Streptococcus pneumoniae.
  • 59% of S. pneumoniae strains were penicillin-resistant, but only caused clinical failure in 8% of cases.

    • Conclusions:

    • Precise aspiration techniques minimize contamination, aiding in differentiating ear canal flora from middle ear pathogens.
    • A high rate of sterile middle ear aspirates post-antibiotic treatment suggests non-bacterial factors may contribute to persistent AOM symptoms.
    • Awareness of penicillin-resistant S. pneumoniae is crucial for appropriate treatment adjustments.