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Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: a tympanocentesis-based, multi-center, cross-sectional study.
BMC Pediatr 2014; 14:157BPed

Abstract

BACKGROUND

Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) are considered major causes of bacterial acute otitis media (AOM) worldwide, but data from Asia on primary causes of AOM are limited. This tympanocentesis-based, multi-center, cross-sectional study assessed bacterial etiology and antimicrobial susceptibility of AOM in Thailand.

METHODS

Children 3 to 59 months presenting with AOM (< 72 hours of onset) who had not received prescribed antibiotics, or subjects who received prescribed antibiotics but remained symptomatic after 48-72 hours (treatment failures), were eligible. Study visits were conducted from April 2008 to August 2009. Bacteria were identified from middle ear fluid collected by tympanocentesis or spontaneous otorrhea swab sampling (< 20% of cases). S. pneumoniae and H. influenzae serotypes were determined and antimicrobial resistance was also assessed.

RESULTS

Of the 123 enrolled children, 112 were included in analysis and 48% of the 118 samples were positive for S. pneumoniae (23% (27/118)), H. influenzae (18% (21/118)), Moraxella catarrhalis (6% (7/118)) or Streptococcus pyogenes (3% (4/118)). The most common pneumococcal serotypes were 19F (26%) and 14 (22%). The majority of H. influenzae isolates were encapsulated (18/21), with 13 type b (Hib) representing 62% of all H. influenzae isolate or 11% of all samples (13/118), and there were only 3 non-typeable isolates. Despite high antibiotic resistance, amoxicillin/clavulanate susceptibility was high. No pneumococcal vaccine use was reported.

CONCLUSIONS

S. pneumoniae and H. influenzae, both frequently antibiotic resistant, were leading causes of bacterial AOM and there was an unexpectedly high burden of Hib in this population unvaccinated by any Hib conjugate vaccine. Conjugate vaccines effective against pneumococcus and H. influenzae could potentially reduce the burden of AOM in this population.

Authors+Show Affiliations

Department of Otolaryngology, Queen Sirikit National Institute of Child Health, 420/8 Rajvithi Road, Rajthevee, Bangkok 10400, Thailand. pintakorn@yahoo.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24947736

Citation

Intakorn, Pavinee, et al. "Haemophilus Influenzae Type B as an Important Cause of Culture-positive Acute Otitis Media in Young Children in Thailand: a Tympanocentesis-based, Multi-center, Cross-sectional Study." BMC Pediatrics, vol. 14, 2014, p. 157.
Intakorn P, Sonsuwan N, Noknu S, et al. Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: a tympanocentesis-based, multi-center, cross-sectional study. BMC Pediatr. 2014;14:157.
Intakorn, P., Sonsuwan, N., Noknu, S., Moungthong, G., Pirçon, J. Y., Liu, Y., ... Hausdorff, W. P. (2014). Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: a tympanocentesis-based, multi-center, cross-sectional study. BMC Pediatrics, 14, p. 157. doi:10.1186/1471-2431-14-157.
Intakorn P, et al. Haemophilus Influenzae Type B as an Important Cause of Culture-positive Acute Otitis Media in Young Children in Thailand: a Tympanocentesis-based, Multi-center, Cross-sectional Study. BMC Pediatr. 2014 Jun 20;14:157. PubMed PMID: 24947736.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: a tympanocentesis-based, multi-center, cross-sectional study. AU - Intakorn,Pavinee, AU - Sonsuwan,Nuntigar, AU - Noknu,Suwiwan, AU - Moungthong,Greetha, AU - Pirçon,Jean-Yves, AU - Liu,Yanfang, AU - Van Dyke,Melissa K, AU - Hausdorff,William P, Y1 - 2014/06/20/ PY - 2013/10/12/received PY - 2014/06/12/accepted PY - 2014/6/21/entrez PY - 2014/6/21/pubmed PY - 2015/1/23/medline SP - 157 EP - 157 JF - BMC pediatrics JO - BMC Pediatr VL - 14 N2 - BACKGROUND: Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) are considered major causes of bacterial acute otitis media (AOM) worldwide, but data from Asia on primary causes of AOM are limited. This tympanocentesis-based, multi-center, cross-sectional study assessed bacterial etiology and antimicrobial susceptibility of AOM in Thailand. METHODS: Children 3 to 59 months presenting with AOM (< 72 hours of onset) who had not received prescribed antibiotics, or subjects who received prescribed antibiotics but remained symptomatic after 48-72 hours (treatment failures), were eligible. Study visits were conducted from April 2008 to August 2009. Bacteria were identified from middle ear fluid collected by tympanocentesis or spontaneous otorrhea swab sampling (< 20% of cases). S. pneumoniae and H. influenzae serotypes were determined and antimicrobial resistance was also assessed. RESULTS: Of the 123 enrolled children, 112 were included in analysis and 48% of the 118 samples were positive for S. pneumoniae (23% (27/118)), H. influenzae (18% (21/118)), Moraxella catarrhalis (6% (7/118)) or Streptococcus pyogenes (3% (4/118)). The most common pneumococcal serotypes were 19F (26%) and 14 (22%). The majority of H. influenzae isolates were encapsulated (18/21), with 13 type b (Hib) representing 62% of all H. influenzae isolate or 11% of all samples (13/118), and there were only 3 non-typeable isolates. Despite high antibiotic resistance, amoxicillin/clavulanate susceptibility was high. No pneumococcal vaccine use was reported. CONCLUSIONS: S. pneumoniae and H. influenzae, both frequently antibiotic resistant, were leading causes of bacterial AOM and there was an unexpectedly high burden of Hib in this population unvaccinated by any Hib conjugate vaccine. Conjugate vaccines effective against pneumococcus and H. influenzae could potentially reduce the burden of AOM in this population. SN - 1471-2431 UR - https://www.unboundmedicine.com/medline/citation/24947736/Haemophilus_influenzae_type_b_as_an_important_cause_of_culture_positive_acute_otitis_media_in_young_children_in_Thailand:_a_tympanocentesis_based_multi_center_cross_sectional_study_ L2 - https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-14-157 DB - PRIME DP - Unbound Medicine ER -