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Prevalence of antimicrobial-resistant pathogens in middle ear fluid: multinational study of 917 children with acute otitis media.
Antimicrob Agents Chemother 1998; 42(3):589-95AA

Abstract

The management of acute otitis media is complicated by the emergence of resistance to beta-lactam and other antibiotics among common pathogens. We conducted a large, international study of infants and children with acute otitis media to identify pathogens and susceptibility patterns. During the winter of 1994 to 1995, middle ear fluid samples were collected from 917 patients with acute otitis media in Bulgaria, the Czech Republic, Hungary, Romania, Slovakia, Israel, and the United States. A single reference laboratory performed in vitro susceptibility testing. Pathogens were isolated from 62% of the patients. For Streptococcus pneumoniae (30% of the patients), untypeable Haemophilus influenzae (17%), and Moraxella catarrhalis (4%), there was significant variation among geographic regions (P < 0.001). The composite susceptibilities of these three organisms to amoxicillin ranged from 62% in the United States to 89% in Eastern and Central Europe; the corresponding susceptibilities to amoxicillin-clavulanate ranged from 90% in Israel to 95% in Eastern and Central Europe. beta-Lactamase was produced by 31 and 100% of the isolates of H. influenzae and M. catarrhalis, respectively. More isolates of S. pneumoniae were susceptible to amoxicillin (90%) or amoxicillin-clavulanate (90%) than to penicillin (70%; P = 0.002). The prevalence of resistant S. pneumoniae was highest in patients less than 12 months of age. S. pneumoniae, H. influenzae, and M. catarrhalis remain the most important bacterial pathogens in patients with acute otitis media; however, their prevalence is variable and resistance patterns are changing.

Authors+Show Affiliations

Department of Pathology (Clinical Microbiology), Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Ohio 44106, USA.No 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

9517937

Citation

Jacobs, M R., et al. "Prevalence of Antimicrobial-resistant Pathogens in Middle Ear Fluid: Multinational Study of 917 Children With Acute Otitis Media." Antimicrobial Agents and Chemotherapy, vol. 42, no. 3, 1998, pp. 589-95.
Jacobs MR, Dagan R, Appelbaum PC, et al. Prevalence of antimicrobial-resistant pathogens in middle ear fluid: multinational study of 917 children with acute otitis media. Antimicrob Agents Chemother. 1998;42(3):589-95.
Jacobs, M. R., Dagan, R., Appelbaum, P. C., & Burch, D. J. (1998). Prevalence of antimicrobial-resistant pathogens in middle ear fluid: multinational study of 917 children with acute otitis media. Antimicrobial Agents and Chemotherapy, 42(3), pp. 589-95.
Jacobs MR, et al. Prevalence of Antimicrobial-resistant Pathogens in Middle Ear Fluid: Multinational Study of 917 Children With Acute Otitis Media. Antimicrob Agents Chemother. 1998;42(3):589-95. PubMed PMID: 9517937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of antimicrobial-resistant pathogens in middle ear fluid: multinational study of 917 children with acute otitis media. AU - Jacobs,M R, AU - Dagan,R, AU - Appelbaum,P C, AU - Burch,D J, PY - 1998/3/28/pubmed PY - 1998/3/28/medline PY - 1998/3/28/entrez SP - 589 EP - 95 JF - Antimicrobial agents and chemotherapy JO - Antimicrob. Agents Chemother. VL - 42 IS - 3 N2 - The management of acute otitis media is complicated by the emergence of resistance to beta-lactam and other antibiotics among common pathogens. We conducted a large, international study of infants and children with acute otitis media to identify pathogens and susceptibility patterns. During the winter of 1994 to 1995, middle ear fluid samples were collected from 917 patients with acute otitis media in Bulgaria, the Czech Republic, Hungary, Romania, Slovakia, Israel, and the United States. A single reference laboratory performed in vitro susceptibility testing. Pathogens were isolated from 62% of the patients. For Streptococcus pneumoniae (30% of the patients), untypeable Haemophilus influenzae (17%), and Moraxella catarrhalis (4%), there was significant variation among geographic regions (P < 0.001). The composite susceptibilities of these three organisms to amoxicillin ranged from 62% in the United States to 89% in Eastern and Central Europe; the corresponding susceptibilities to amoxicillin-clavulanate ranged from 90% in Israel to 95% in Eastern and Central Europe. beta-Lactamase was produced by 31 and 100% of the isolates of H. influenzae and M. catarrhalis, respectively. More isolates of S. pneumoniae were susceptible to amoxicillin (90%) or amoxicillin-clavulanate (90%) than to penicillin (70%; P = 0.002). The prevalence of resistant S. pneumoniae was highest in patients less than 12 months of age. S. pneumoniae, H. influenzae, and M. catarrhalis remain the most important bacterial pathogens in patients with acute otitis media; however, their prevalence is variable and resistance patterns are changing. SN - 0066-4804 UR - https://www.unboundmedicine.com/medline/citation/9517937/Prevalence_of_antimicrobial_resistant_pathogens_in_middle_ear_fluid:_multinational_study_of_917_children_with_acute_otitis_media_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&amp;pmid=9517937 DB - PRIME DP - Unbound Medicine ER -