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Methicillin-resistant Staphylococcus aureus colonization in otitis-prone children.

Abstract

OBJECTIVES

To examine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among children undergoing bilateral myringotomy and tube insertion with or without adenoidectomy for chronic otitis media with effusion or recurrent acute otitis media, as well as to examine the occurrence of postoperative otorrhea in children who have vs do not have MRSA colonization.

DESIGN

Prospective cohort study.

SETTING

Hospital-based pediatric otolaryngology practice in a metropolitan area.

PATIENTS

Seventy-six children (51 boys and 25 girls), with a mean (SD) age of 3.6 (1.8) years.

INTERVENTIONS

Cultures for S aureus from the nasopharynx, external auditory canals, middle ears, and adenoid were obtained at the time of surgery, as well as middle ear cultures for bacteriologic culture and sensitivity. Patients were followed up for the development of otorrhea.

MAIN OUTCOME MEASURES

Prevalence of MRSA colonization and predictors of subsequent otorrhea.

RESULTS

The prevalence of S aureus colonization at the time of bilateral myringotomy and tube insertion was 7.9% (95% CI, 3.0%-16.4%), and the prevalence of MRSA colonization was 3.9% (95% CI, 0.8%-11.1%). All MRSA-positive specimens were resistant to erythromycin, and 2 were resistant to clindamycin. The mean (SD) follow-up period was 11.6 (3.6) months. Twenty-seven patients (35.5% [95% CI, 25.1%-46.9%]) developed at least 1 episode of otorrhea. One of 3 patients with MRSA colonization had subsequent otorrhea. The only predictor of otorrhea was younger age.

CONCLUSIONS

The prevalence of MRSA colonization among otitis-prone children was similar to rates reported among the general pediatric community. Methicillin-resistant S aureus colonization at the time of bilateral myringotomy and tube insertion was not predictive of subsequent otorrhea.

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  • Publisher Full Text
  • Authors

    Marzouk HA, Nathawad R, Hammerschlag MR, Weedon J, Bachman D, Goldstein NA

    Source

    MeSH

    Acute Disease
    Bacteriological Techniques
    Child, Preschool
    Cohort Studies
    Cross-Sectional Studies
    Female
    Humans
    Incidence
    Male
    Methicillin-Resistant Staphylococcus aureus
    Microbial Sensitivity Tests
    Middle Ear Ventilation
    New York City
    Otitis Media with Effusion
    Otitis Media, Suppurative
    Prospective Studies
    Recurrence
    Staphylococcal Infections

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22183900