LEIBOVITZ E, LIBSON S, GREENBERG D, PORAT N, LEIBERMAN A, DAGAN R; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. G-1855.

Ben-Gurion Univ., Beer-Sheva, Israel.

BACKGROUND: The relationship between Pnc presence in NP after successful antibiotic treatment of an initial AOM episode and the etiology of the following AOM episode is not clear. METHODS: From 1997 through 2002, 932 children aged 3-36 months with AOM were enrolled in various double tympanocentesis studies (tympanocentesis performed on day 1 in all patients and day 4-6 in those initially culture +). 530 (57%) successfully completed treatment (pathogen eradicated on day 4-6 or no pathogen in middle ear fluid [MEF] on day 1 and clinical improvement at end of therapy [EOT], day 11-14). NP-Pnc cultures were obtained from 494/530 (92%) patients at EOT. Patients were followed for 2-3 weeks after EOT and additional MEF culture was obtained if AOM recurred. Serotype and PFGE were determined on Pnc isolates. RESULTS: MEF cultures were positive on day 1 in 417/530 (79%) patients, with 517 pathogens: 303 (59%) H. influenzae (Hi), 191 (37%) Pnc, 23 (4%) others. NP-Pnc at EOT was found in 208/494 (42%) patients. AOM recurred in 110/530 (21%) patients, 88 (80%) with positive MEF (108 pathogens): 55 (51%) Pnc, 50 (46%) Hi, 3 (3%) others. NP-Pnc was present more frequently at EOT in evaluable patients who later developed Pnc-AOM than in patients without recurrent-AOM (34/51 [67%] vs 152/391 [38%], respectively, P<.01). Recurrent Pnc-AOM episodes were more common in patients with positive NP-Pnc cultures at EOT compared with patients without Pnc (34/208 [16%] vs 17/286 [6%], respectively, P<.01). Serotypes were available in 30/34 Pnc pairs (NP at EOT and MEF at recurrence). The same serotype was identified in 24/30 (80%) and PFGE showed complete identity in 22/23 available pairs. CONCLUSIONS:1) Early recurrent Pnc-AOM was more common in patients in whom Pnc was present in NP at EOT compared with those without Pnc; 2) Most early recurrent Pnc-AOM episodes were caused by isolates present in NP at EOT of the previous AOM episode.

Publication Types:

• Meeting Abstracts

Keywords:

• Acute Disease
• Anti-Bacterial Agents
• Antigens, Bacterial
• Child
• Ear, Middle
• Haemophilus influenzae
• Humans
• Nasopharynx
• Otitis Media
• Recurrence
• Streptococcus pneumoniae
• immunology
• therapy

Other ID:

• GWAIDS0026156

UI: 102265780

From Meeting Abstracts