Bacterial aetiology of recalcitrant acute otitis media in 62 children—high risk of pathogen colonisation after treatment

Korona-Głowniak, Izabela; Mazur, Elżbieta; Żychowski, Piotr; Niedzielska, G; Kozioł-Montewka, Maria; Malm, Anna

doi:10.1111/coa.12986

Cited by 3 publications

(5 citation statements)

References 13 publications

(17 reference statements)

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“…By multiplex PCR, H. influenzae, S. pneumoniae and M. catarrhalis were detected in 24, 18 and 8% of OME patients, respectively, similarly to other reports [3,8,9]. Bacterial isolation rates from patients with AOM have been found to range from 50 to 90%, but to be lower (21 to 70%) in patients with OME [7,9,10]. The role of bacteria in aetiology of OME has been controversial.…”

Section: Discussionsupporting

confidence: 77%

“…Considering that H. influenzae, S. pneumoniae and M. catarrhalis are the most frequent pathogens detected in acute otitis media and are able to ascend through the Eustachian tube, causing ciliary damage to the airway epithelium and disrupting mucociliary flow, this may result in conditions for persistence in the middle ear compartment [9,10,24,25]. In some cases, especially when OME is not clearly related to a mechanical obstruction of the Eustachian tube, the Toynbee effect of negative pressure within the middle ear may help the ascendance of microbes through the tube, leading to colonization of the middle ear, which may be pivotal in OME pathogenesis [26].…”

Section: Standard Bacterial Culture and Sensitive Molecular Detectionmentioning

confidence: 99%

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Bacterial aetiology of chronic otitis media with effusion in children - risk factors

Korona-Głowniak

Wisniewska

Juda

et al. 2020

J of Otolaryngol - Head & Neck Surg

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Background Otitis media with effusion (OME) may occur spontaneously because of poor Eustachian tube function or as an inflammatory response following AOM. Bacterial involvement in OME has been widely reported, with various available methods to identify pathogens from middle ear effusion, including traditional culture methods and polymerase chain reaction (PCR). Objectives The primary goal of this study was to evaluate the bacteriological profile of middle ear effusion in OME. Risk factors of the bacterial OME aetiology were also identified. Methods Middle ear effusions (MEF) from 50 children, aged 2–8 years, diagnosed by ENT and undergoing routine tympanostomy tube placement were collected. MEF samples were streaked on standard microbiological media. Next, DNA was isolated from MEF samples and analysed with multiplex PCR for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Alloiococcus otitidis. Results In multiplex PCR assay 37 (74%) of 50 children were positive for at least one of the four microorganisms. In 27.0% positive children multiple bacterial pathogens were identified. A. otitidis was the most frequently identified in positive MEF children (59.5%). By multiplex PCR, H. influenzae, S. pneumoniae and M. catarrhalis were detected in 24, 18 and 8% of OME patients, respectively. There was significant association between bilateral infection and H. influenzae aetiology of OME. Conclusions Overall we found OME predominantly a single otopathogen infection caused mainly by A. otitidis, which is difficult in identification using standard culture method, ahead to S. pneumoniae and H. influenzae. However, one third of MEF samples had multiple bacterial pathogens.

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Section: Discussionsupporting

confidence: 77%

Section: Standard Bacterial Culture and Sensitive Molecular Detectionmentioning

confidence: 99%

Bacterial aetiology of chronic otitis media with effusion in children - risk factors

Korona-Głowniak

Wisniewska

Juda

et al. 2020

J of Otolaryngol - Head & Neck Surg

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“…Acute otitis media (AOM) is a common childhood infection, occurring most frequently as a consequence of viral upper respiratory tract infections, but treated mainly with antibiotics. The leading causes of bacterial AOM worldwide are Streptococcus pneumoniae , non-typeable Haemophilus influenzae , Moraxella catarrhalis , and group A Streptococcus [ 8 – 10 ]. In approximately 80% of children aged 2–5 years AOM is diagnosed at least once, and 30–40% of them have recurrent episodes [ 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…In our previous study, we observed the high prevalence of antibiotic-resistant otopathogens in recalcitrant AOM and the high colonization rate by the same otopathogen species after completion of antibiotic therapy [ 10 ]. In this study we evaluate the relationship between the pneumococcal strains obtained from the nasopharynx (NP) and oropharynx (OP) and the middle ear fluid (MEF) of children during AOM and during post-treatment visits, based on their phenotypic and genotypic characteristics performed by analyses of serotype, antibiotic susceptibility patterns and multilocus sequence typing (MLST).…”

Section: Introductionmentioning

confidence: 99%

Resistant Streptococcus pneumoniae strains in children with acute otitis media– high risk of persistent colonization after treatment

et al. 2018

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BackgroundDespite advances in the development of pneumococcal conjugate vaccines, acute otitis media (AOM) is a common childhood infection, caused mainly by Streptococcus pneumoniae. It has been suggested that persistence of pneumococcal nasopharyngeal carriage is a risk factor for subsequent recurrent infections.MethodsIn this study we evaluate the relationship between 55 pneumococcal strains obtained from nasopharynx/oropharynx (NP/OP) and middle ear fluid (MEF) of 62 children, aged between 1 and 16 years, during AOM (including recurrent/treatment failure AOM, and post-treatment visits), based on their phenotypic and genotypic characteristics performed by analyses of serotype, antibiotic susceptibility patterns and multilocus sequence typing.ResultsS.pneumoniae was isolated from 27.4% of MEF samples; it constituted 43.6% of all positive bacterial samples from MEF samples. There was statistically significant concordance between isolation from the MEF sample and NP/OP colonization by S. pneumoniae (p < 0.0001). During post-treatment visits S.pneumoniae was isolated from 20.8% of children; 91% of them were positive in pneumococcal NP/OP culture during AOM. The serotypes belonging to 10- and 13-valent pneumococcal conjugate vaccines constituted 84% and 92% of the strains, respectively. Multidrug resistance was found in 84% of the strains. According to multivariate analysis, pneumococcal colonization after antibiotic therapy was significantly associated with shorter length of therapy in children with bilateral AOM.ConclusionsHigh persistent prevalence of antibiotic-resistant S.pneumoniae strains in children with AOM after unsuccessful bacterial eradication may presumably be regarded as a predisposing factor of infection recurrence.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3398-9) contains supplementary material, which is available to authorized users.

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“…Our recent work shows that S. pneumoniae colonizes the host’s upper airway with poor availability of methionine ( 24 ). A large body of literature indicated the remarkable resilience of S. pneumoniae against antibiotic treatment in children with acute otitis media ( 57 ), as manifested by the reisolation of the same strains in different otitis media episodes in the same children ( 58 , 59 ). In this context, understanding the mechanisms of stress adaptation by S. pneumoniae is of great importance for improving therapeutic strategies and developing new antimicrobials.…”

Section: Discussionmentioning

confidence: 99%

Amino Acid Starvation-Induced Glutamine Accumulation Enhances Pneumococcal Survival

Cheng-wang

Liu

et al. 2023

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Bacterial aetiology of recalcitrant acute otitis media in 62 children—high risk of pathogen colonisation after treatment

Cited by 3 publications

References 13 publications

Bacterial aetiology of chronic otitis media with effusion in children - risk factors

Bacterial aetiology of chronic otitis media with effusion in children - risk factors

Resistant Streptococcus pneumoniae strains in children with acute otitis media– high risk of persistent colonization after treatment

Amino Acid Starvation-Induced Glutamine Accumulation Enhances Pneumococcal Survival

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