Otitis Media in Children: To Treat or Not to Treat?

Bluestone, Charles D.

doi:10.1056/nejm198206103062305

Cited by 135 publications

(47 citation statements)

References 56 publications

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“…Though ear infection can be caused by viruses and fungi, the major causes of ear infections are bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumoniae and Escherichia coli which are found in the skin of the external ear and enter into the middle ear through a chronic perforation. 5,6 In addition, antimicrobial resistance profile of bacteria varies among population because of the difference in geography, local antimicrobial prescribing practices and prevalence of resistant bacterial strains in a given area. 7 So there should be up to date information on microbial resistance pattern at national and local levels to guide the rational use of the existing antimicrobial drugs.…”

Section: Introductionmentioning

confidence: 99%

Bacterial isolates and drug susceptibility patterns of ear discharge from patients with ear infection at Shaheed Monsur Ali Medical College.

Akter

Shamsuzzaman

Nehar

et al. 2017

Bangladesh J Med Microbiol

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Ear infection is a common problem for both children and adults especially in developing countries. However in Bangladesh particularly in the study area, there is no recent data that shows the magnitude of the problem. A retrospective study was conducted from from April, 2013 to March, 2014 at Shaheed Monsur Ali Medical College. Ear discharge samples were cultured on MacConkey agar, blood agar and chocolate agar plates. A total of 115 ear discharge samples were tested for bacterial isolation and 86 (74.78%) cases were found positive; 49 (56.98%) were gram negative bacteria and the predominant isolate were S. aureus 21 (24.42%) followed by Pseudomonas aeruginosa 20 (23.26%). Of individuals 70 (81.40%) had single bacterial infection and 16 (18.60%) had mixed bacterial infections. Under five children were more affected by ear infection. The prevalence of ear infection was higher in females than males (64.35% vs 35.65%) (P=0.879). The prevalence of ear infection was very high in the study area. Majority of the bacterial isolates were resistant to multiple antibiotics. Hence antibiotics susceptibility test is mandatory before prescribing any antibiotics.

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Section: Introductionmentioning

confidence: 99%

Bacterial isolates and drug susceptibility patterns of ear discharge from patients with ear infection at Shaheed Monsur Ali Medical College.

Akter

Shamsuzzaman

Nehar

et al. 2017

Bangladesh J Med Microbiol

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“…One such subversive pathogen is the gram-negative bacterium nontypeable Haemophilus influenzae (NTHi), which exemplifies an important, as yet underexplored, human respiratory pathogen in both children and adults (1). In children, it causes otitis media (OM), the most common childhood infection and the leading cause of conductive hearing loss (2,3), while in adults, it exacerbates chronic obstructive pulmonary diseases (COPD), the fourth leading cause of death in the United States (4,5). Despite the need for prophylactic measures, development of a vaccine for preventing NTHi infections has been difficult and still remains a great challenge (1).…”

Section: Introductionmentioning

confidence: 99%

Exploitation of Host Epithelial Signaling Networks by Respiratory Bacterial Pathogens

2003

J Pharmacol Sci

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Abstract. Although tremendous effort has been put towards identifying the surface molecules of nontypeable Haemophilus influenzae (NTHi) for vaccine development over the past decades, it is only recently that we have begun to appreciate the intricate host epithelial signaling networks activated by NTHi, an important human pathogen causing respiratory infections. From what has been reported, it is evident that NTHi activates multiple signaling pathways in host epithelial cells that, in turn, inadvertently contribute to the pathogenesis. Among those signaling pathways, activation of NF-kB leads to up-regulation of IL-1b, IL-8 and TNF-a , mucin MUC2 and Tolllike receptor 2 (TLR2), whereas activation of p38 MAP kinase mediates not only up-regulation of inflammatory mediators and mucin MUC5AC but also down-regulation of TLR2. Interestingly, NTHi-induced activation of the PI3K-Akt pathway, however, leads to inhibition of p38 mitogen-activated protein (MAP) kinase. Moreover, the TGF-b-Smad signaling pathway cooperates with NF-kB to mediate up-regulation of mucin MUC2. Finally, glucocorticoids synergistically enhance NTHi-induced TLR2 expression via specific up-regulation of the MAP kinase phosphatase-1 that, in turn, leads to inactivation of p38 MAP kinase, the negative regulator for TLR2 expression. These studies may bring new insights into the molecular pathogenesis of NTHi-induced infections and open up novel therapeutic targets for these diseases.

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“…Acute otitis media (AOM) and otitis media with effusion (OME) are common diseases and important otological problems in childhood (3,4). Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the three major pathogens in AOM as well as in OME (4,20).…”

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confidence: 99%

High Incidence of Alloiococcus otitidis in Children with Otitis Media, Despite Treatment with Antibiotics

et al. 2006

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Acute otitis media (AOM) and otitis media with effusion (OME) are common diseases in childhood. Alloiococcus otitidis is a newly recognized species of gram-positive bacterium which was recently discovered as a pathogen associated with OME. Although some studies show that A. otitidis is frequently detected in children with OME, no study is available concerning the clinical efficiency of antibiotics against this organism. The prevalence of A. otitidis in 116 middle ear effusion specimens from 36 AOM and 52 OME patients was examined by culture and PCR. In addition, the prevalence of the bacterium was retrospectively investigated in relation to antibiotic use. A. otitidis was detected in 20 (50%) AOM and 47 (61%) OME specimens. The organism was the most frequent bacterium in AOM as well as in OME and was highly detected even in patients who had been treated with antibiotics, such as beta-lactams or erythromycin. The incidence of A. otitidis in our study was higher than that in Western countries, and our results suggest that drug-resistant strains of A. otitidis may be frequently spread in Japanese children. Our study suggests that antibiotics such as beta-lactams or erythromycin may not be sufficiently effective to eliminate this organism. Further investigation is expected to reveal the clinical role of the organism in otitis media.Acute otitis media (AOM) and otitis media with effusion (OME) are common diseases and important otological problems in childhood (3, 4). Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the three major pathogens in AOM as well as in OME (4,20).In 1989, an unknown gram-positive coccus was recovered from middle ear effusions of children with OME (6). This organism was determined to be a new species of bacterium by 16S rRNA analysis and was named Alloiococcus otitis (1); later the name was revised to Alloiococcus otitidis (9). This organism is difficult to detect in middle ear effusions by conventional culture, because it shows slow growth in vitro and could hinder recovery of the organism from clinical specimens (6). On the other hand, by PCR, A. otitidis was detected in about 50% of OME patients, a higher rate than for the three major pathogens (2, 14). These studies suggest that A. otitidis is one of the major pathogens of OME.However, only a limited number of studies of A. otitidis have been conducted, and no clinical study of A. otitidis is available, although a few studies are available concerning the prevalence or the bacteriological character of this organism. Studies concerning the prevalence of A. otitidis in OME have been performed only in Finland (13,14,18) and in the United Kingdom (2). Other than in these two countries, only a few clinical strains of A. otitidis have been isolated in the United States (5, 6), Turkey (16), Spain (8), and Brazil (5). In Asian countries, even the isolation of A. otitidis has not been reported yet. In addition, as regards the detection of A. otitidis in AOM patients, only the study by Leskinen et al. (19) is available...

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Otitis Media in Children: To Treat or Not to Treat?

Cited by 135 publications

References 56 publications

Bacterial isolates and drug susceptibility patterns of ear discharge from patients with ear infection at Shaheed Monsur Ali Medical College.

Bacterial isolates and drug susceptibility patterns of ear discharge from patients with ear infection at Shaheed Monsur Ali Medical College.

Exploitation of Host Epithelial Signaling Networks by Respiratory Bacterial Pathogens

High Incidence of Alloiococcus otitidis in Children with Otitis Media, Despite Treatment with Antibiotics

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