Otitis media with effusion in Lebanese children: prevalence and pathogen susceptibility

Nasser, Soumana C.; Moukarzel, Nabil; Nehme, Ali; Ahmad, Hassan Haidar; Kabbara, B.; Haddad, Antoine

doi:10.1017/s0022215111001587

Cited by 8 publications

(7 citation statements)

References 28 publications

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“…Furthermore, more than 50% of H . influenzae isolates from children with COME in Lebanon were β-lactamase-negative ampicillin-resistant strains [ 76 ], however these strains were not typed.…”

Section: Resultsmentioning

confidence: 99%

“…influenzae strains, have been isolated from the MEF of patients with OM in Mexico [ 35 ], Lebanon [ 76 ] and Japan [ 135 ]. The BLNAR strains identified from MEF in the latter two reports [ 76 , 135 ] have been isolated elsewhere in the upper respiratory tract and reflect the most frequently detected mechanism of ampicillin resistance for H . influenzae across the world [ 136 ].…”

Section: Discussionmentioning

confidence: 99%

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Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

et al. 2016

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BackgroundOtitis media (OM) is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention.MethodsA systematic review of published reports of microbiology of acute otitis media (AOM) and otitis media with effusion (OME) from January, 1970 to August 2014, was performed using PubMed databases.ResultsThis review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR) rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine.ConclusionsGlobally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the complex combination of otopathogens within the middle ear, ultimately aiming to reduce the risk of chronic and recurrent OM in vulnerable populations.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

et al. 2016

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“…The organisms most frequently causing OM and bacterial resistance have been found to vary considerably over time and geographical region ( Table 5 ). These differences among studies may be due, in part, to differences in inclusion criteria, sample sizes, microbiological methodology, climate, and geographical areas ( 5 8 16 19 21 22 ).…”

Section: Discussionmentioning

confidence: 99%

Bacterial Species and Antibiotic Sensitivity in Korean Patients Diagnosed with Acute Otitis Media and Otitis Media with Effusion

et al. 2017

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Changes over time in pathogens and their antibiotic sensitivity resulting from the recent overuse and misuse of antibiotics in otitis media (OM) have complicated treatment. This study evaluated changes over 5 years in principal pathogens and their antibiotic sensitivity in patients in Korea diagnosed with acute OM (AOM) and OM with effusion (OME). The study population consisted of 683 patients who visited the outpatient department of otorhinolaryngology in 7 tertiary hospitals in Korea between January 2010 and May 2015 and were diagnosed with acute AOM or OME. Aural discharge or middle ear fluid were collected from patients in the operating room or outpatient department and subjected to tests of bacterial identification and antibiotic sensitivity. The overall bacteria detection rate of AOM was 62.3% and OME was 40.9%. The most frequently isolated Gram-positive bacterial species was coagulase negative Staphylococcus aureus (CNS) followed by methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and Streptococcus pneumonia (SP), whereas the most frequently isolated Gram-negative bacterium was Pseudomonas aeruginosa (PA). Regardless of OM subtype, ≥ 80% of CNS and MRSA strains were resistant to penicillin (PC) and tetracycline (TC); isolated MRSA strains showed low sensitivity to other antibiotics, with 100% resistant to PC, TC, cefoxitin (CFT), and erythromycin (EM); and isolated PA showed low sensitivity to quinolone antibiotics, including ciprofloxacin (CIP) and levofloxacin (LFX), and to aminoglycosides. Bacterial species and antibiotic sensitivity did not change significantly over 5 years. The rate of detection of MRSA was higher in OME than in previous studies. As bacterial predominance and antibiotic sensitivity could change over time, continuous and periodic surveillance is necessary in guiding appropriate antibacterial therapy.

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“…Fluid from the ears of children with otitis media with effusion usually does not show infection with bacteria. In some cases, however, the fluid may contain organisms such as Streptococcus pneumonia, Haemophilus influenzae, Moraxella catarrhailus or other bacteria [18]. Medical management would potentially be of greatest benefit if it could speed the resolution of an episode of OME.…”

Section: Introductionmentioning

confidence: 99%

Otitis Media with Effusion in Children: A Follow up Study in West Baghdad, Iraq

A¹

2014

Commun Disord Deaf Stud Hearing Aids

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Objective: To study the clinical, audiological and radiological characteristics as well as treatment outcome of children less than 12 years old suffered from Otitis Media with Effusion (OME) from West Baghdad, Iraq. Materials and Methods:This is a follow up study performed upon 180 child under 12 years old, diagnosed having OME by clinical, audiological and radiological means, they were treated in Al-Ramadi and Al-Fallujah General Hospitals drained from West Baghdad and Al-Anbar Governorate, during the period from May 2010 to July 2012. The data obtained from the parents, clinical examination and investigations like Pure Tone Audiometry (PTA), tympanometry and lateral soft tissue x-ray of the neck had been done. The treatment outcome studied after follow up for six months.Results: There were 54.4% boys and 45.6% girls. The main presenting symptom was hearing impairment (brought by family) (47.2%) and the main presenting sign was retraction of tympanic membrane (91.7%), the mean amount of hearing loss by PTA was 22.6 ± 5.5 dB. In 92.2% of patients tympanometry was type B. The size of the adenoid measured by Adenoid\Nasopharyngeal ratio was located mainly on Grade 3+ (43.3%). All the patients were given medical treatment, 61.1% of them responded. Patients that failed to response to medical treatment underwent different modalities of surgical means represented mainly by myringotomy and adenotonsillectomy. Conclusion:There was significant correlation between the size of adenoid and the type of tympanogram and hearing threshold. The treatment was mainly medical, while surgical means if indicated they were myringotomy accompanied mainly with adenotonsillectomy.

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Otitis media with effusion in Lebanese children: prevalence and pathogen susceptibility

Abstract: In these children with persistent otitis media with effusion, H influenzae was the most prevalent bacteria. It showed a high incidence of resistance to the antibiotics most commonly prescribed to treat acute otitis media.

Cited by 8 publications

References 28 publications

Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

Bacterial Species and Antibiotic Sensitivity in Korean Patients Diagnosed with Acute Otitis Media and Otitis Media with Effusion

Otitis Media with Effusion in Children: A Follow up Study in West Baghdad, Iraq

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