Severe acute middle ear infections: Microbiology and treatment

Heslop, Anders; Ovesen, Therese

doi:10.1016/j.ijporl.2006.06.009

Cited by 33 publications

(21 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Accordingly, no association between strictness in antibiotic recommendation for uncomplicated acute otitis media and mastoiditis hospitalizations was confirmed. These results are in accordance with a Finnish cohort study [9], but opposed to reports in several clinical studies where bias due to selection cannot be excluded [9,10,[15][16][17]. It should also be noted, that pneumococcal vaccination was not included in the national childhood vaccine program until 2006.…”

Section: Discussionsupporting

confidence: 89%

Acute mastoiditis in Norway: No evidence for an increase

Kværner¹,

Bentdal²,

Karevold³

2007

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 89%

Acute mastoiditis in Norway: No evidence for an increase

Kværner¹,

Bentdal²,

Karevold³

2007

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

“…5 AOM patients and it is possible that these patients were sicker and were therefore given antibiotics, quite according to the guidelines. The bacteriological findings are in concordance with other studies [6,8,10]. Streptococcus pneumoniae was the most common cause of mastoiditis in the present study and was the overwhelming finding in cultures from the mastoid.…”

Section: Discussionsupporting

confidence: 93%

“…Recent studies support that the trend toward less liberal use of antibiotics against AOM does not seem to increase the number of cases of mastoiditis [2][3][4]. However, other authors have reported an increase in the number of mastoiditis patients in recent years [5][6][7][8][9]. In the present study, patients were given antibiotics prior to hospital care in 39% of the acute mastoiditis patients.…”

Section: Discussionsupporting

confidence: 46%

Acute mastoiditis in southern Sweden: a study of occurrence and clinical course of acute mastoiditis before and after introduction of new treatment recommendations for AOM

Stenfeldt

Hermansson

2010

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Watchful waiting was recommended as an option for uncomplicated episodes of acute otitis media in Sweden in the year 2000. Concern was raised that these recommendations would lead to a higher incidence of acute mastoiditis. The aim of this study was to map the occurrence, treatment policy and the clinical course of mastoiditis before and after the new treatment recommendations were introduced. Included in the study were all patients (adults and children) who were admitted to two ENT departments in southern Sweden for acute mastoiditis from 1996 to 2005. A total of 42 cases of mastoiditis were identified: 23 during the first period of 1996-2000 and 19 during 2001-2005. Mastoidectomy was performed in 14 patients during the first period and in 8 during the second period. As much as 39% of mastoiditis patients received antibiotics before hospital care, but had no improvement. There was no indication that the number of patients with acute mastoiditis was increasing after new treatment recommendation of AOM. There was no increase in the occurrence of mastoidectomy. Severe complications of mastoiditis were rare. Although there were potentially threatening complications of mastoiditis in the study, these did not lead to sequelae. It is important to follow up the consequences when treatment recommendations of AOM are changed.

show abstract

“…These infections range from mild illnesses such as pharyngitis and impetigo to diseases of greater severity, including necrotizing fasciitis and streptococcal toxic shock syndrome (11,19,32,41,43). Thus, the organism has evolved to colonize a number of physiologically distinct host sites.…”

mentioning

confidence: 99%

“…Thus, the organism has evolved to colonize a number of physiologically distinct host sites. The role of GAS in otitis media (OM) is often underappreciated due to the effectiveness of beta-lactam antibiotics in elimination of GAS; however, there have been studies showing GAS to be one of the top 4 causative agents of OM infection and, more importantly, of development of OM complications such as acute mastoiditis (19,35,43). Mastoiditis is a severe bacterial infection of the mastoid bone and air cell system, often requiring surgical intervention and aggressive antibiotic treatment (40).…”

mentioning

confidence: 99%

Loss of the Group A Streptococcus Regulator Srv Decreases Biofilm Formation In Vivo in an Otitis Media Model of Infection

et al. 2010

View full text Add to dashboard Cite

Group A Streptococcus (GAS) is a common causative agent of pharyngitis, but the role of GAS in otitis media is underappreciated. In this study, we sought to test the hypothesis that GAS colonizes the middle ear and establishes itself in localized, three-dimensional communities representative of biofilms. To test this hypothesis, the middle ears of chinchillas were infected with either a strain of GAS capable of forming biofilms in vitro (MGAS5005) or a strain deficient in biofilm formation due to the lack of the transcriptional regulator Srv (MGAS5005 ⌬srv). Infection resulted in the formation of large, macroscopic structures within the middle ears of MGAS5005-and MGAS5005 ⌬srv-infected animals. Plate counts, scanning electron microscopy, LIVE/ DEAD staining, and Gram staining revealed a difference in the distributions of MGAS5005 versus MGAS5005 ⌬srv in the infected samples. High numbers of CFU of MGAS5005 ⌬srv were isolated from the middle ear effusion, and MGAS5005 ⌬srv was found randomly distributed throughout the excised macroscopic structure. In contrast, MGAS5005 was found in densely packed microcolonies indicative of biofilms within the excised material from the middle ear. CFU levels of MGAS5005 from the effusion were significantly lower than that of MGAS5005 ⌬srv early during the course of infection. Allelic replacement of the chromosomally encoded streptococcal cysteine protease (speB) in the MGAS5005 ⌬srv background restored biofilm formation in vivo. Interestingly, our results suggest that GAS naturally forms a biofilm during otitis media but that biofilm formation is not required to establish infection following transbullar inoculation of chinchillas.

show abstract

Severe acute middle ear infections: Microbiology and treatment

Cited by 33 publications

References 10 publications

Acute mastoiditis in Norway: No evidence for an increase

Acute mastoiditis in Norway: No evidence for an increase

Acute mastoiditis in southern Sweden: a study of occurrence and clinical course of acute mastoiditis before and after introduction of new treatment recommendations for AOM

Loss of the Group A Streptococcus Regulator Srv Decreases Biofilm Formation In Vivo in an Otitis Media Model of Infection

Contact Info

Product

Resources

About