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

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Authors

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

Institution

Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.

Source

Archives of otolaryngology--head & neck surgery 137:12 2011 Dec pg 1217-22

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