Abstract
BackgroundAcute Otitis Media (AOM) is an important and common disease of childhood. Bacteria isolated from cases of clinically problematic AOM in German children were identified and characterized.MethodsIn a prospective non-interventional study in German children between 3 months and less than 60 months of age with Ear, Nose and Throat Specialist –confirmed AOM, middle ear fluid was obtained by tympanocentesis (when clinically indicated) or by careful sampling of otorrhea through/at an existing perforation.ResultsIn 100 children with severe AOM, Haemophilus influenzae was identified in 21% (18/21, 85.7% were non-typeable [NTHi]), Streptococcus pneumoniae in 10%, S. pyogenes in 13% and Moraxella catarrhalis in 1%. H. influenzae was the most frequently identified pathogen in children from 12 months of age. H. influenzae and S. pneumoniae were equally prevalent in children aged 3–11 months, but S. pyogenes was most frequently isolated in this age group. NTHi AOM disease appeared prevalent in all ages.ConclusionsNTHi, S. pneumoniae and S. pyogenes are implicated as important causes of complicated AOM in children in Germany. NTHi disease appears prevalent in all ages. The impact of vaccination to prevent NTHi and S. pneumoniae AOM may be substantial in this population and is worth investigating.
Highlights
Acute Otitis Media (AOM) is an important and common disease of childhood
The majority (74%) children had received at least one 7-valent pneumococcal conjugate vaccine (PCV7) dose. Clinical symptoms such as fever >39.0°C, ear discharge, lethargy, irritability and anorexia were reported more frequently among children with cultures positive for S. pneumoniae compared to children with cultures positive for H. influenzae
In a large evaluation of AOM etiology conducted in Israel, S. pyogenes AOM was observed more frequently in older children than in younger children, and was often associated with acute tympanic membrane (TM) perforation [9]
Summary
Acute Otitis Media (AOM) is an important and common disease of childhood. Bacteria isolated from cases of clinically problematic AOM in German children were identified and characterized. Acute Otitis Media (AOM) is one of the most frequently reported childhood diseases and is the primary reason for antibiotic use in children [1]. Perforation of the tympanic membrane (TM) can occur as a consequence of AOM. This has potentially important long term clinical consequences [1]. Widespread vaccination with 7-valent pneumococcal conjugate vaccine (PCV7) has reduced outpatient visits due to AOM in children
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