TY - JOUR T1 - Microbiology of bacteria causing recurrent acute otitis media (AOM) and AOM treatment failure in young children in Spain: shifting pathogens in the post-pneumococcal conjugate vaccination era. AU - Pumarola,Felix, AU - Marès,Josep, AU - Losada,Isabel, AU - Minguella,Isabel, AU - Moraga,Fernando, AU - Tarragó,David, AU - Aguilera,Ulla, AU - Casanovas,Josep M, AU - Gadea,Gloria, AU - Trías,Elisenda, AU - Cenoz,Santiago, AU - Sistiaga,Alessandra, AU - García-Corbeira,Pilar, AU - Pirçon,Jean-Yves, AU - Marano,Cinzia, AU - Hausdorff,William P, Y1 - 2013/06/06/ PY - 2012/11/01/received PY - 2013/04/02/revised PY - 2013/04/06/accepted PY - 2013/6/11/entrez PY - 2013/6/12/pubmed PY - 2014/3/29/medline KW - Antibiotic resistance KW - Haemophilus influenzae KW - Otitis media KW - Streptococcus pneumoniae KW - Tympanocentesis SP - 1231 EP - 6 JF - International journal of pediatric otorhinolaryngology JO - Int J Pediatr Otorhinolaryngol VL - 77 IS - 8 N2 - OBJECTIVE: To prospectively identify the bacterial aetiology and antimicrobial susceptibility of problematic (recurrent and treatment failure) acute otitis media in Spanish children several years after the introduction of 7-valent pneumococcal conjugate vaccine. METHODS: Tympanocentesis or careful sampling of spontaneous otorrhoea was performed on children aged 3 to <36 months with recurrent acute otitis media, acute otitis media treatment failure or unresolved acute otitis media. RESULTS: 105 acute otitis media episodes (77 sampled by tympanocentesis, 28 otorrhoea samples) were evaluated: 46 recurrent, 35 treatment failures, 24 unresolved acute otitis media. 74 episodes (70.4%) had at least one bacterium identified on culture: Streptococcus pneumoniae was identified in 21 episodes, Haemophilus influenzae (all non-typeable) in 44, Streptococcus pyogenes in 2, Moraxella catarrhalis in 2. No statistically significant difference in bacterial aetiology by episode type was detected. Non-typeable H. influenzae was the most commonly isolated pathogen in all acute otitis media types and in all age sub-groups. Forty percent of S. pneumoniae isolates were multi-drug resistant. Pneumococcal serotype 19A was the most frequently identified serotype (7/21 episodes). Multi-drug resistance was found in 56% of 19A isolates. Of non-typeable H. influenzae isolates, 15% were ampicillin resistant and 13% were amoxicillin/clavulanate resistant. S. pneumoniae and non-typeable H. influenzae DNA were each detected in 57% of samples culture negative for these pathogens, including 12 co-infections. CONCLUSION: Combining culture and polymerase chain reaction results, H. influenzae and S. pneumoniae may be implicated in 70% and 43% of clinically problematic bacterial acute otitis media episodes, respectively. The impact of new vaccines to prevent both S. pneumoniae and non-typeable H. influenzae acute otitis media may be substantial in this population and is worth investigating. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/23746414/Microbiology_of_bacteria_causing_recurrent_acute_otitis_media__AOM__and_AOM_treatment_failure_in_young_children_in_Spain:_shifting_pathogens_in_the_post_pneumococcal_conjugate_vaccination_era_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(13)00157-2 DB - PRIME DP - Unbound Medicine ER -