成人急性中耳炎における薬剤耐性肺炎球菌検出と集団保育児との同居, 年齢層の関係について

Abstract

In the treatment of adult patients with acute otitis media (AOM), it has been assumed that >65 years of age or living with children attending a day nursery, are background factors for infection with drug-resistant Streptococcus pneumoniae (DRSP). However, few reports have discussed the relationship between these background factors and adult patients with AOM. In this study, I reviewed 209 cases of adult patients with AOM in whom S. pneumoniae was detected via myringotomies performed between 1995 and 2015. I retrospectively analyzed the relationship between drug resistance and drug-resistant S. pneumoniae detection frequency on the basis of patient age range, whether patients had been coresiding with children who were attending a day nursery, and, if they were, the age composition of those patients. An extremely high percentage of these cases included patients between 30 and 39 years of age, among whom the number of patients who had been coresiding with children who attended group daycare was significantly higher than the number among those not in that age group. The patients who had coresided with children attending group daycare had significantly higher DRSP detection rates and significantly worse drug resistance than the patients who had not-coresided with children attending group daycare. Furthermore, among the patients who had coresided with children who attending group daycare, those with children <2 years of age had significantly higher DRSP detection rates and significantly worse drug resistance than the patients with children >2 years of age. No significant differences in drug resistance and DRSP detection rates were detected between patients <65 years of age and those >65 years of age. Therefore, we think that during examinations of adult patients with AOM, physicians should always confirm whether the patient is coresiding with children who attend group daycare and, if they are, determin the ages of those children.