Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: a tympanocentesis-based, multi-center, cross-sectional study

Abstract

BackgroundStreptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) are considered major causes of bacterial acute otitis media (AOM) worldwide, but data from Asia on primary causes of AOM are limited. This tympanocentesis-based, multi-center, cross-sectional study assessed bacterial etiology and antimicrobial susceptibility of AOM in Thailand.MethodsChildren 3 to 59 months presenting with AOM (< 72 hours of onset) who had not received prescribed antibiotics, or subjects who received prescribed antibiotics but remained symptomatic after 48–72 hours (treatment failures), were eligible. Study visits were conducted from April 2008 to August 2009. Bacteria were identified from middle ear fluid collected by tympanocentesis or spontaneous otorrhea swab sampling (< 20% of cases). S. pneumoniae and H. influenzae serotypes were determined and antimicrobial resistance was also assessed.ResultsOf the 123 enrolled children, 112 were included in analysis and 48% of the 118 samples were positive for S. pneumoniae (23% (27/118)), H. influenzae (18% (21/118)), Moraxella catarrhalis (6% (7/118)) or Streptococcus pyogenes (3% (4/118)). The most common pneumococcal serotypes were 19F (26%) and 14 (22%). The majority of H. influenzae isolates were encapsulated (18/21), with 13 type b (Hib) representing 62% of all H. influenzae isolate or 11% of all samples (13/118), and there were only 3 non-typeable isolates. Despite high antibiotic resistance, amoxicillin/clavulanate susceptibility was high. No pneumococcal vaccine use was reported.ConclusionsS. pneumoniae and H. influenzae, both frequently antibiotic resistant, were leading causes of bacterial AOM and there was an unexpectedly high burden of Hib in this population unvaccinated by any Hib conjugate vaccine. Conjugate vaccines effective against pneumococcus and H. influenzae could potentially reduce the burden of AOM in this population.

Antibiotic resistance of Streptococcus pneumoniae in children with acute otitis media treatment failure

“…This is higher than the previously reported number of cases of AOM that were bacteria-positive in children who had also received prior oral antibiotic therapy (i.e. 48 and 53À58% reported by Intakorn et al [15] and Li et al [16], respectively). We could not identify the causative agent of the AOM in the remaining 34% of children in our study because thorough diagnostic testing on a broad spectrum of microbial pathogens was limited with the small amount of MEF obtained.…”

Ear microbiota and middle ear disease: a longitudinal pilot study of Aboriginal children in a remote south Australian setting

“…In keeping with previous studies in Aboriginal children in remote Australia [ 17 ], and globally [ 38 , 39 ], we found H. influenzae , and to a lesser extent, M. catarrhalis , to be associated with chronic and perforated OM. We also found Oligella to be significantly more abundant in those with ear disease with perforation, detected in 16% of all ear swabs and with a relative abundance up to 60%.…”

Proteomic Study Identifies Glycolytic and Inflammation Pathways Involved in Recurrent Otitis Media

“…Remarkably, some pathogens have adapted to NETs, particularly H. influenzae, which can initiate NETs and tightly associate with these structures, avoiding phagocytic escape, thus resulting in chronic infection [37]. In fact, this pathogen is a leading cause of ROAM, as already reported by some studies [38,39].…”

“…Then we took into consideration only proteins which were identified with at least 3 unique peptides [29]. In spots 21,35,38,25,44,12,2,27,3,19,1,11,45,20,32A and 4, only 1 protein was identified with at least 3 unique peptides in addition to the contaminants (keratins and hornerin). For all other spots (8,29,23,40,26,5,42) we used the Mascot score and the sequence coverage to pinpoint the most abundant protein present in the spot.…”