Prevalência de bactérias em crianças com otite média com efusão

Abstract

Objectives: 1) To determine the prevalence of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in middle ear effusions of children with otitis media with effusion undergoing myringotomy; 2) to compare the results obtained by culture and PCR; and 3) to determine the susceptibility of bacterial isolates to penicillin. Methods:We analyzed 128 middle ear effusion specimens from 75 children (age = 11 months to 10 years; mean = 34.7 months). Patients with recurrent otitis media had documented middle ear effusion for = 6 weeks, and chronic otitis media with effusion for = 3 months. The patients had no signs of acute otitis media or respiratory tract infection and were not on antibiotic therapy. Aspiration was done through tympanocentesis with an Alden-Senturia trap. Bacteriological studies were initiated less than 15 minutes after specimen collection. Part of the sample was stored at -20 o C for later multiplex PCR analysis. Statistical analysis employed McNemar s χ 2 test.Results: Bacteria were cultured in 32 (25.1%) out of 128 samples and the pathogens under investigation were found in 25 (19.6%). PCR was positive for bacteria in 73 (57.0%) specimens: 50 (39.1%) for H. influenzae, 16 (12.5%) for S. pneumoniae, and 13 (10.2%) for M. catarrhalis. All the culture-positive samples were PCR-positive, but 48 (65.7%) of the PCR-positive specimens were culture-negative. PCR was significantly more sensitive than culture (p < 0.01) to identify bacteria. Resistance to penicillin was as follows: M. catarrhalis = 100%; S. pneumoniae = 62.5% and H. influenzae = 23% of the isolates. Conclusions:The prevalence of bacteria in otitis media with effusion in a group of Brazilian children was similar to that reported for other countries. H. influenzae was the most frequent microorganism observed. This suggests that bacteria may play a role in the pathogenesis of otitis media with effusion. In addition, PCR was more sensitive to detect bacteria in middle ear effusion as compared to conventional culture methods. Penicillin resistance was similar to that reported for other countries for pneumococci and moraxella, but beta-lactamase production by H. influenza was lower than that reported for other countries.J Pediatr (Rio J). 2004;80(1):41-8: Otitis media, otitis media with effusion/microbiology, ear, middle/ microbiology, PCR, prevalence studies, child.

The Prevalence of Bacterial Etiologies Causing Otitis Media with Effusion among Omani Children

“…13,14 Our detection rate using direct culture was comparable to Park et al and Pereira et al results as they have reported positive cultures of 14% and 19% respectively. 6,9 Both papers reported the same order of our detected bacteria with H. influenzae being the most common one. However, Daneil et al reported a higher percentage of positive cultures of 45%.…”

“…7 As only the efficacy of the acute phase management of OME with both antibiotics and corticoids has been proven, the understanding of microbiology and sensitivity of causative organisms of OME will help in reducing both the complications and the need for surgical intervention. 8,9 In 1950s, Senturia et al has opened the door for microbiological studies of MEE. 10 Since then, the evidence of bacterial infection as an important factor in the pathogenesis of OME has been supported by multiple methods.…”

“…Those studies agreed that the most common bacteria in the MEE includes Hemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis with variation in the order and detection rates. 3,6,9,11,12 The main objective of this study was to determine the prevalence of bacterial etiologies of OME among Omani children using both direct culture and PCR. We also aim to evaluate the antibiotic susceptibility of bacteria to penicillins and the serotype of isolated Streptococcus pneumoniae.…”

Presence or absence of bacteria in otitis media with effusion?

“…No estudo Determinação da prevalência de bactérias em crianças com otite média com efusão, capitaneado por Pereira et al 8 , o índice de culturas positivas foi de 25,1%, enquanto a PCR foi positiva em 57% das amostras estudadas. Embora o emprego da PCR para investigação das amostras de OME seja pioneiro em nosso país e os resultados estejam de acordo com a literatura internacional [9][10][11] , os autores tomam o cuidado de lembrar que há discrepância quanto ao significado da PCR positiva: trata-se de bactérias viáveis ou apenas restos fossilizados de bactérias (fragmentos de DNA)?…”

Presença ou ausência de bactérias na otite média com efusão?

“…6 Moreover, some doubts have been raised as to the use of pneumococcal conjugate vaccine and AOM. 7 In the study Prevalence of bacteria in children with otitis media with effusion , written by Pereira et al, 8 the rate of positive culture findings was 25.1%, whereas PCR was positive in 57% of the analyzed samples. Although the use of PCR for the investigation of OME is a pioneering technique in Brazil and the results are consistent with the international literature, 9-11 the authors show that there is some discrepancy as to the positive PCR findings obtained: were viable bacteria detected or are they just fossilized remnants of bacteria (DNA fragments)?…”