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Objective: To analyze the symptoms and signs of acute otitis media (AOM) in infants under one-year-old and the risk factors of AOM. Methods: Care information and clinical characteristics of a total of 304 full-term delivery infants with normal hearing who were examined in Shanghai Children's Hospital from January to December 2018 were included in the analysis. All infants were followed up to one-year-old and the clinical characteristics of AOM infants were collected. χ2 test was used to analyze whether there was a statistically significant difference between the AOM group (AOM infants) and the control group (infants without AOM) in terms of feeding status, daily care, going out, living environment, pneumococcal vaccination, and so on. Logistic regression model was used to explore the risk factors for AOM in infants under one-year-old. Results: In 304 infants, 177 developed AOM, and the age of AOM infants was (5.65±2.03) months. Compared with the control group, AOM group had higher rates of spitting up milk (P=0.000), frequent ears digging (P=0.021), participation in early education activities (P=0.000) and recurrent respiratory infection (P=0.000), and lower rate of pneumococcal vaccination (P=0.000). Logistic regression analysis showed that vomiting (OR=2.774, P=0.002), participation in early education activities (OR=3.785, P=0.000) and recurrent respiratory infection (OR=3.638, P=0.000) were risk factors for AOM in infants, and pneumococcal vaccination was a protective factor (OR=0.320, P=0.000). Conclusion: AOM is a high-incidence disease in infants under one-year-old in Shanghai. Insisting on scientific feeding position, reducing spitting and paying attention to the extra protection when participating in public activities such as early education may reduce the occurrence of AOM. Pneumococcal vaccination may help prevent AOM.
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PURPOSE: AOM is the most common bacterial URI in children. The bacteriology and antibiotic Tx of AOM in children has been studied in many countries. But, there is few study of causative pathogens and antibiotic Tx of AOM in our country. In this aspect, we performed prospective clinical study to confirm the causative pathogens and assess the clinical responses of cefprozil in AOM patients. METHODS: Thirty three AOM patients enrolled in this study. Tympanocentesis for isolation of causa tive pathogens were performed before Tx of cefprozil. The study patients received cefprozil with dose of 15 mg/kg/bid.po/day for 10-12 days, and initially assessed the clinical response at 4-5 days after receiving cefprozil and finally at the end visit. In vitro susceptibility tests of cefprozil to isolated pathogens were done by disc diffusion method, and in vitro susceptibility tests of cefaclor and cefixime to isolated pathogens were simultaneously performed. RESULTS: Bacterial pathogens[S. pneumoniae(10), H. influenzae(5), S. aureus(2), M. catarrhalis(1) and Group A stretococcus(1)] were isolated from 19 patients. Clinically, all patients had history of abrupt high fever except one. Tympanic perforation was dominant in pathogens isolated cases, and otalgia was significantly developed in non-pathogens isolated cases. The ages of pathogens isolated cases were usually below 2 years. Eighty four point nine percent of the patients including two cases with isolation of intermediate resistant S. pneumoniae were clinically improved. Antimicrobial in vitro activity to S. pneumoniae of cefprozil were superior than that of cefacor and cefixime. CONCLUSION: We confirm that bacteria has the causative role in about 60% cases, and S. pneumoniae is the most common pathogen. Clinically, there were some differences in symptoms, signs and ages between pathogens isolated and non-pathogens isolated cases. The clinical responses of cefprozil in our patients revealed similar outcomes to other countries. And we reconfirm that cefprozil may be clinically effective in cases of AOM due to intermediate resistant S. pneumoniae.