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Resistant Streptococcus pneumoniae strains in children with acute otitis media- high risk of persistent colonization after treatment.
BMC Infect Dis 2018; 18(1):478BI

Abstract

BACKGROUND

Despite advances in the development of pneumococcal conjugate vaccines, acute otitis media (AOM) is a common childhood infection, caused mainly by Streptococcus pneumoniae. It has been suggested that persistence of pneumococcal nasopharyngeal carriage is a risk factor for subsequent recurrent infections.

METHODS

In this study we evaluate the relationship between 55 pneumococcal strains obtained from nasopharynx/oropharynx (NP/OP) and middle ear fluid (MEF) of 62 children, aged between 1 and 16 years, during AOM (including recurrent/treatment failure AOM, and post-treatment visits), based on their phenotypic and genotypic characteristics performed by analyses of serotype, antibiotic susceptibility patterns and multilocus sequence typing.

RESULTS

S.pneumoniae was isolated from 27.4% of MEF samples; it constituted 43.6% of all positive bacterial samples from MEF samples. There was statistically significant concordance between isolation from the MEF sample and NP/OP colonization by S. pneumoniae (p < 0.0001). During post-treatment visits S.pneumoniae was isolated from 20.8% of children; 91% of them were positive in pneumococcal NP/OP culture during AOM. The serotypes belonging to 10- and 13-valent pneumococcal conjugated vaccines constituted 84% and 92% of the strains, respectively. Multidrug resistance was found in 84% of the strains. According to multivariate analysis, pneumococcal colonization after antibiotic therapy was significantly associated with shorter length of therapy in children with bilateral AOM.

CONCLUSIONS

High persistent prevalence of antibiotic-resistant S.pneumoniae strains in children with AOM after unsuccessful bacterial eradication may presumably be regarded as a predisposing factor of infection recurrence.

Authors+Show Affiliations

Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics, Medical University of Lublin, Chodzki 1 Street, 20-093, Lublin, Poland. iza.glowniak@umlub.pl.Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin, Lublin, Poland.Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics, Medical University of Lublin, Chodzki 1 Street, 20-093, Lublin, Poland.Department of Medical Microbiology, Medical University of Lublin, Lublin, Poland.Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin, Lublin, Poland.Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics, Medical University of Lublin, Chodzki 1 Street, 20-093, Lublin, Poland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30253754

Citation

Korona-Glowniak, Izabela, et al. "Resistant Streptococcus Pneumoniae Strains in Children With Acute Otitis Media- High Risk of Persistent Colonization After Treatment." BMC Infectious Diseases, vol. 18, no. 1, 2018, p. 478.
Korona-Glowniak I, Zychowski P, Siwiec R, et al. Resistant Streptococcus pneumoniae strains in children with acute otitis media- high risk of persistent colonization after treatment. BMC Infect Dis. 2018;18(1):478.
Korona-Glowniak, I., Zychowski, P., Siwiec, R., Mazur, E., Niedzielska, G., & Malm, A. (2018). Resistant Streptococcus pneumoniae strains in children with acute otitis media- high risk of persistent colonization after treatment. BMC Infectious Diseases, 18(1), p. 478. doi:10.1186/s12879-018-3398-9.
Korona-Glowniak I, et al. Resistant Streptococcus Pneumoniae Strains in Children With Acute Otitis Media- High Risk of Persistent Colonization After Treatment. BMC Infect Dis. 2018 Sep 25;18(1):478. PubMed PMID: 30253754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resistant Streptococcus pneumoniae strains in children with acute otitis media- high risk of persistent colonization after treatment. AU - Korona-Glowniak,Izabela, AU - Zychowski,Piotr, AU - Siwiec,Radoslaw, AU - Mazur,Elżbieta, AU - Niedzielska,Grażyna, AU - Malm,Anna, Y1 - 2018/09/25/ PY - 2017/10/23/received PY - 2018/09/19/accepted PY - 2018/9/27/entrez PY - 2018/9/27/pubmed PY - 2018/11/1/medline KW - Acute otitis media KW - Antibiotic resistance KW - MLST KW - Risk factors KW - Streptococcus pneumoniae SP - 478 EP - 478 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 18 IS - 1 N2 - BACKGROUND: Despite advances in the development of pneumococcal conjugate vaccines, acute otitis media (AOM) is a common childhood infection, caused mainly by Streptococcus pneumoniae. It has been suggested that persistence of pneumococcal nasopharyngeal carriage is a risk factor for subsequent recurrent infections. METHODS: In this study we evaluate the relationship between 55 pneumococcal strains obtained from nasopharynx/oropharynx (NP/OP) and middle ear fluid (MEF) of 62 children, aged between 1 and 16 years, during AOM (including recurrent/treatment failure AOM, and post-treatment visits), based on their phenotypic and genotypic characteristics performed by analyses of serotype, antibiotic susceptibility patterns and multilocus sequence typing. RESULTS: S.pneumoniae was isolated from 27.4% of MEF samples; it constituted 43.6% of all positive bacterial samples from MEF samples. There was statistically significant concordance between isolation from the MEF sample and NP/OP colonization by S. pneumoniae (p < 0.0001). During post-treatment visits S.pneumoniae was isolated from 20.8% of children; 91% of them were positive in pneumococcal NP/OP culture during AOM. The serotypes belonging to 10- and 13-valent pneumococcal conjugated vaccines constituted 84% and 92% of the strains, respectively. Multidrug resistance was found in 84% of the strains. According to multivariate analysis, pneumococcal colonization after antibiotic therapy was significantly associated with shorter length of therapy in children with bilateral AOM. CONCLUSIONS: High persistent prevalence of antibiotic-resistant S.pneumoniae strains in children with AOM after unsuccessful bacterial eradication may presumably be regarded as a predisposing factor of infection recurrence. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/30253754/Resistant_Streptococcus_pneumoniae_strains_in_children_with_acute_otitis_media__high_risk_of_persistent_colonization_after_treatment_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-3398-9 DB - PRIME DP - Unbound Medicine ER -