Non-capsulated and capsulated Haemophilus influenzaein children with acute otitis media in Venezuela: a prospective epidemiological study

Abstract

BackgroundNon-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae are major causes of bacterial acute otitis media (AOM). Data regarding AOM are limited in Latin America. This is the first active surveillance in a private setting in Venezuela to characterize the bacterial etiology of AOM in children < 5 years of age.MethodsBetween December 2008 and December 2009, 91 AOM episodes (including sporadic, recurrent and treatment failures) were studied in 87 children enrolled into a medical center in Caracas, Venezuela. Middle ear fluid samples were collected either by tympanocentesis or spontaneous otorrhea swab sampling method. Standard laboratory and microbiological techniques were used to identify bacteria and test for antimicrobial resistance. The results were interpreted according to Clinical Laboratory Standards Institute (CLSI) 2009 for non-meningitis isolates. All statistical analyses were performed using SAS 9.1 and Microsoft Excel (for graphical purposes).ResultsOverall, bacteria were cultured from 69.2% (63 of the 91 episodes); at least one pathogen (S. pneumoniae, H. influenzae, S. pyogenes or M. catarrhalis) was cultured from 65.9% (60/91) of episodes. H. influenzae (55.5%; 35/63 episodes) and S. pneumoniae (34.9%; 22/63 episodes) were the most frequently reported bacteria. Among H. influenzae isolates, 62.9% (22/35 episodes) were non-capsulated (NTHi) and 31.4% (11/35 episodes) were capsulated including types d, a, c and f, across all age groups. Low antibiotic resistance for H. influenzae was observed to amoxicillin/ampicillin (5.7%; 2/35 samples). NTHi was isolated in four of the six H. influenzae positive samples (66.7%) from recurrent episodes.ConclusionsWe found H. influenzae and S. pneumoniae to be the main pathogens causing AOM in Venezuela. Pneumococcal conjugate vaccines with efficacy against these bacterial pathogens may have the potential to maximize protection against AOM.

Bacterial and Respiratory Viral Interactions in the Etiology of Acute Otitis Media in HIV-infected and HIV-uninfected South African Children

“…The resistance of S. pneumoniae serotype 19A to penicillin was mainly intermediate, thereby highlighting the lack of resistance from this usually penicillin-resistant serotype. 39 These findings are consistent with recent reports from other countries, 23 , 24 and underscore the observed change in antibiotic resistance to penicillin over the past decade, particularly because a high percentage of samples were resistant to penicillin in the previous South African study. 28 Similarly, most other vaccine serotypes were also intermediate in their resistant to penicillin.…”

“…Our study also indicated that NTHi-positive episodes were resistant to trimethoprim/sulfamethoxazole (60.8%) and ampicillin (13.9%), consistent with previous reports from South Africa. 24 , 28 Furthermore, the low resistance for S. pneumoniae and NTHi to amoxicillin/clavulanate supports its continued use in the treatment of AOM as recommended in South Africa. 37 In addition to antibiotic treatment for AOM, vaccination indicated against AOM may help control the associated disease burden.…”

Non-typeable Haemophilus influenzae-associated early pregnancy loss: an emerging neonatal and maternal pathogen

“…Non-typeable Haemophilus influenzae (NTHi) often causes upper respiratory tract infections and although rare, carries a potential risk of invasive disease especially in at-risk populations such as the elderly, children and neonates [1,2]. Since the introduction of H. Influenzae vaccine, there has been a dramatic decline in mortality and morbidity associated with invasive disease caused by serotype b [3].…”

Etiology of acute otitis media and serotype distribution of Streptococcus pneumoniae and Haemophilus influenzae in Chilean children <5 years of age

“…Studies conducted in the past assessed the etiology and serotype distribution of bacterial pathogens causing AOM in various countries [ 27 – 30 ] including Latin American countries such as Chile, [ 31 ] Colombia, [ 32 ] Mexico, [ 33 ] and Venezuela. [ 34 ] However, recent epidemiological data in terms of AOM disease burden in Chile are limited.…”