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.
Subject(s)
Otitis Media/diagnosis , Pneumococcal Infections/diagnosis , Streptococcus pneumoniae/isolation & purification , Acute Disease , Adolescent , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Drug Resistance, Multiple, Bacterial/drug effects , Female , Genotype , Humans , Infant , Male , Nasopharynx/microbiology , Odds Ratio , Oropharynx/microbiology , Otitis Media/drug therapy , Otitis Media/microbiology , Pneumococcal Infections/drug therapy , Pneumococcal Infections/microbiology , Prospective Studies , Serogroup , Streptococcus pneumoniae/geneticsABSTRACT
Staphylococcus caprae was originally isolated from goat milk. This uncommon coagulase-negative staphylococcus, usually associated with animals, has only infrequently been detected in human clinical specimens. Its association with acute otitis media has not been demonstrated so far. The study reports the first isolation of S. caprae from the middle ear fluid of a 12-month-old infant with recurrent, bilateral acute otitis media. Biochemical traits and susceptibility pattern of the isolated strain are also presented.
Subject(s)
Ear, Middle/microbiology , Otitis Media/microbiology , Staphylococcal Infections/microbiology , Staphylococcus/isolation & purification , Acute Disease , Anti-Bacterial Agents/pharmacology , Humans , Infant , Male , Microbial Sensitivity Tests , Staphylococcus/drug effects , Staphylococcus/geneticsABSTRACT
UNLABELLED: Choanal atresia is a rare congenital disease, it occurs in 1/8000 live newborns. AIM OF THE STUDY: retrospective review of patients with choanal atresia treated at the Department of Pediatric Otolaryngology of Medical University in Lublin. Twenty-two children were evaluated, 16 females, 6 males, age range from 6th day to 11th year of life, operated between 2004 and 2009. We analized: age of the parents, mothers diseases during pregnancy, place of live, type of atresia, associated abnormalities, age of children at time of surgery, results of treatment. The age of parents didn't differ significantly from the mean age of parents of children without abnormality. Choanal atresia was bilateral in 10 patients (45%), unilateral in 12 cases (55%)--right-sided in 75% and left-sided in 3 children. The membranous barrier was stated in 60.7%, bone in 25%, and mixed in 14.7%. Choanal atresia was an isolated disease in 12 patients, and in 10 it was associated with other abnormalities. The most common were: central nervous system abnormalities (5 children), heart defect (5), facial dysmorphy (4), hearing loss only in 2 cases. All patients were operated with transnasal technique with stents placement for 6-8 weeks period. The necessity of repleacing the stents occurred in 4 patients because of tendency of the granulation. These problems were absent in patients who were operated during the newborn period. Undoubtedly, the transnasal technique is a procedure by choice, decision, to place a stent or not, depend on the experience of the surgeon and his/her own results.
