Otitis Media Infections Research Articles

Effect of Combined Antibiotics and Biofilm Formation in Some Bacterial Pathogens from Otitis Media among Children in Baghdad, Iraq

Otitis media bacterial infections during childhood may contribute to the development of repeatednasopharyngeal infections and it is complicated of recurrent or chronic middle ear diseases, especially withmultidrug resistant strains.The results of antibiotic synergism for the most prevalent three bacterial species, isolated from otitis mediainfections in children, and had the highest antibiotic resistance was revealed that combinations ceftazidimeamikacin and ceftazidime- ciprofloxacin displayed synergistic activity fractional inhibitory concentration(FIC ? 0.5) against the most of tested isolates; Pseudomonas aeruginosa, Porteus mirabilis, and Klebsiellapneumonia. In the biofilm test all tested isolates were showed biofilm production by tissue culture platemethod (TCP), in the present study, the strong biofilm production was most prevalent in Pseudomonasaeruginosa (100%) followed by S. aureus (71.4%). Biofilm formation increases the activity of antibioticsin children otitis media infections and using antibiotics combinations may be essential for optimummanagement of OM patients.

Phenotypic and Genetic Effects of Wi-Fi Waves on Some Bacterial Species Isolated from Otitis Media Infection

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Biological and Pharmacological Potential of Xylitol: A Molecular Insight of Unique Metabolism.

Xylitol is a white crystalline, amorphous sugar alcohol and low-calorie sweetener. Xylitol prevents demineralization of teeth and bones, otitis media infection, respiratory tract infections, inflammation and cancer progression. NADPH generated in xylitol metabolism aid in the treatment of glucose-6-phosphate deficiency-associated hemolytic anemia. Moreover, it has a negligible effect on blood glucose and plasma insulin levels due to its unique metabolism. Its diverse applications in pharmaceuticals, cosmetics, food and polymer industries fueled its market growth and made it one of the top 12 bio-products. Recently, xylitol has also been used as a drug carrier due to its high permeability and non-toxic nature. However, it become a challenge to fulfil the rapidly increasing market demand of xylitol. Xylitol is present in fruit and vegetables, but at very low concentrations, which is not adequate to satisfy the consumer demand. With the passage of time, other methods including chemical catalysis, microbial and enzymatic biotransformation, have also been developed for its large-scale production. Nevertheless, large scale production still suffers from high cost of production. In this review, we summarize some alternative approaches and recent advancements that significantly improve the yield and lower the cost of production.

Vaccinating to Prevent Antibiotic Use: Potential Impact of a Group A Streptococcus Vaccine on Acute Respiratory Infections

Background: Group A Streptococcus (GAS) causes acute upper respiratory tract infections that are frequently treated with antibiotics. GAS vaccines in development may prevent both disease and outpatient antibiotic prescribing. We estimated (1) the incidences of GAS-attributable pharyngitis, sinusitis, and acute otitis media (AOM) infections in the United States; (2) the proportion of these infections resulting in antibiotic prescriptions; and (3) the incidence of infection and antibiotic prescribing potentially preventable by vaccination against GAS. Methods: We estimated annual rates of US outpatient visits and antibiotic prescriptions for pharyngitis, sinusitis, and AOM using physician office and emergency department visit data in the National Ambulatory Care Survey and National Hospital Ambulatory Medical Care Survey from 2012 to 2015. We supplemented this with visits to other outpatient settings (eg, urgent care) from the 2016 IBM MarketScan Commercial Database. We estimated the proportion of episodes attributable to GAS and to GAS emm types targeted by a 30-valent vaccine in development using data from previously conducted etiology studies. We estimated the incidence of disease and antibiotic prescribing preventable by a vaccine meeting the WHO 80% efficacy target for preventing noninvasive GAS disease, with doses administered during infancy and at age 4 years. We estimated the proportion of outpatient antibiotic prescribing preventable by vaccination by dividing estimates by total antibiotic dispensations, estimated from the IQVIA TM dataset. Results: Among individuals aged 0–64 years, GAS causes 27.3 (95% CI, 24.6–30.6) ambulatory care visits and 16.4 (95% CI, 14.5–18.6) outpatient antibiotic prescriptions per 1,000 population annually for pharyngitis, sinusitis, and AOM combined, representing 2.1% (95% CI, 1.8%–2.4%) of all outpatient antibiotic prescriptions. Among children aged 3–9 years, GAS-attributable incidence includes 124.4 (95% CI, 109.0–142.1) visits and 77.1 (95% CI, 65.7–90.6) antibiotic prescriptions per 1,000 population annually, representing 8.6% (95% CI, 7.3%–10.1%) of antibiotic prescriptions in this age group. Individual-level direct protection from a 30-valent vaccine meeting the WHO target could prevent 26.0% (95% CI, 24.0%–28.1%) of pharyngitis visits; 17.3% (95% CI, 15.5%–19.5%) of pharyngitis, sinusitis, and AOM visits; and 5.5% (95% CI, 4.7%–6.4%) of outpatient antibiotic prescriptions among children aged 3–9 years. If vaccination eliminated the need for antibiotic treatment of pharyngitis (for which GAS is the only etiology warranting antibiotic treatment), the total effects of vaccination could include the prevention of up to 17.2% (95% CI, 15.0%–19.6%) and 6.8% (95% CI, 6.3%–7.3%) of antibiotic prescriptions among persons 3–9 years and 0–64 years of age, respectively. Conclusions: In addition to preventing infections and healthcare visits, an efficacious GAS vaccine could prevent a substantial volume of outpatient antibiotic prescribing in the United States.Funding: This work was supported by the Centers for Disease Control and Prevention. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.Disclosures: Laura M. King is a contractor employed by Northrop Grumman Corporation to fulfill research needs at the Centers for Disease Control and Prevention as part of a contract covering many positions and tasks. All other authors declare no conflicts.

Early Childhood Antibiotic Treatment for Otitis Media and Other Respiratory Tract Infections Is Associated With Risk of Type 1 Diabetes: A Nationwide Register-Based Study With Sibling Analysis.

OBJECTIVEThe effect of early-life antibiotic treatment on the risk of type 1 diabetes is debated. This study assessed this question, applying a register-based design in children up to age 10 years including a large sibling-control analysis.RESEARCH DESIGN AND METHODSAll singleton children (n = 797,318) born in Sweden between 1 July 2005 and 30 September 2013 were included and monitored to 31 December 2014. Cox proportional hazards models, adjusted for parental and perinatal characteristics, were applied, and stratified models were used to account for unmeasured confounders shared by siblings.RESULTSType 1 diabetes developed in 1,297 children during the follow-up (median 4.0 years [range 0–8.3]). Prescribed antibiotics in the 1st year of life (23.8%) were associated with an increased risk of type 1 diabetes (adjusted hazard ratio [HR] 1.19 [95% CI 1.05–1.36]), with larger effect estimates among children delivered by cesarean section (P for interaction = 0.016). The association was driven by exposure to antibiotics primarily used for acute otitis media and respiratory tract infections. Further, we found an association of antibiotic prescriptions in pregnancy (22.5%) with type 1 diabetes (adjusted HR 1.15 [95% CI 1.00–1.32]). In general, sibling analysis supported these results, albeit often with statistically nonsignificant associations.CONCLUSIONSDispensed prescription of antibiotics, mainly for acute otitis media and respiratory tract infections, in the 1st year of life is associated with an increased risk of type 1 diabetes before age 10 years, most prominently in children delivered by cesarean section.

Susceptibility of microorganisms isolated from otitis media pus to cigarette capsule and Nicotiana tabacum

Otitis media is a perforation of the middle ear caused by pathogenic microorganisms which leads to hearing impairment. There is a need for alternative methods to the use of antibiotics in combatting the impairment owing to the challenge of antibiotics resistance. This study is aimed at identifying and determining susceptibility pattern of bacterial isolates from otitis media patients to cigarette capsule and Nicotiana tabacum extract. Forty eight samples were collected from a tertiary hospital in Abeokuta Ogun state- 28 (58.33%) from males and 20 (41.67%) from females with highest occurrence in children below the age of 5 (60%).Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniaeandProteus mirabiliswere isolated. The two different products of cigarette capsules used showed significant (P < 0.05) zones of inhibition onPseudomonas aeruginosa and Streptococcus pneumonia respectively. Results also revealed that Nicotiana tabacum extract had significant effect (P < 0.05) onKlebsiella pneumonia, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureusandStreptococcus pneumonia at 0.5 mg, 1.0mg and 2.0mg. This study shows the antibacterial activity of Nicotiana tabacum methanolic leaf extract making it a promising raw material in the production of new classes of antibiotics against otitis media infection.

EFFECT OF PASSIVE SMOKING ON OTITIS MEDIA IN CHILDREN- AN OBSERVATIONAL STUDY

Background: Otitis media is a common infection in young children. Multiple studies have looked at the impact of environmental tobacco smoke(passive smoking) on children and the incidence of otitis media infection.
 Objectives: This study was conducted to evaluate the correlation of environmental and parental smoking on otitis media in children of age range brtween 0-12age.
 Methods: This was an observational study conducted on 320 clinically diagnosed otitis media in 0-12 year age children. The study was performed in five year period from March 2009 to March 2014. All the patients were observed in routine OPD check up by a single observer. A pre designed Performa was used to record relevent information like patient data, history, clinical findings and investigation report from individual pregnancy.
 Results: The male predominance was observed. Forth group wass of 9-12 year age with most prevalent patients having either from of disease; this was because of more than three years of exposure to passive smoking. The most Prevalent disease was observed in under proverty line people. Patients were having perental smoking at home were more prevalent to AOM and CSOM. 
 Conclution: The results support a relationship between the exposure of passive smoking abd prevalence of recurrent AOM and CSOM in children.

Association between otitis media infection and failed hearing screenings in children

This study aims to assess prospectively whether there is an association between frequencies of upper respiratory tract infections (URTI) or asthma in early childhood and failed otoacoustic emission (OAE) screenings later in life. There are no clear recommendations for hearing testing following acute otitis media (AOM) infection. This is a retrospective, practice based chart review. Participants from a primary care setting were 517 pre-adolescent and adolescent children (49.9% female) (ages 10–21; mean, 15 y/o), who had presented with at least one specific bacterial URTI (AOM, Group A Streptococcus (GAS) tonsillitis, or Influenza) during childhood. Hearing testing was recorded incidentally at all subsequent routine health care maintenance visits (OAE hearing screen). Simple linear regression analyses were performed using R (v3.4.4). We found that number of episodes of AOM infections strongly correlated with number of failed OAE screenings later in life (F = 76.37; P = <0.001; R2 = 0.1279), while GAS (F = 1.859; P = 0.1733; R2 = 0.0016) or Influenza infection (F = 2.624; P = 0.1059; R2 = 0.0031) were not associated with failed OAE screening. Correlation between number of AOM infections and number of failed OAE screenings was not strengthened by presence of asthma. This study found evidence of an association between childhood history of AOM and failed OAE screenings in adolescence. Since this population may be at a higher risk for developing permanent or fluctuating hearing losses, further studies to clarify indications and timing of standard audiological testing among these children should be considered.

An Interesting Case of Gradenigo Syndrome

ABSTRACTGradenigo syndrome is a rare complication of acute otitis media infections, and early diagnosis and treatment of the condition are imperative. In this report, we present a case of a 22-month-old girl who developed acute, acquired esotropia associated with recurrent episodes of otitis media, which resolved after antibiotic treatment. To our knowledge, our patient is one of the youngest children reported in the literature to present with presumed Gradenigo syndrome and the only case of recurrent episodes of acquired esotropia and concurrent otitis media within the short time span of 1 month. We hope to add new information to the existing literature and to aid in the understanding of the pathophysiology and management of this condition.

Impact of existing vaccines in reducing antibiotic resistance: Primary and secondary effects

Vaccines impact antibiotic-resistant infections in two ways: through a direct reduction in the organisms and strains carrying resistant genes that are specifically targeted by the vaccine and also via a secondary effect through a reduction in febrile illnesses that often lead to the use of antibiotics. We review here the impact of pneumococcal conjugate vaccines (PCVs) on the prevalence of antibiotic-resistant disease and antibiotic usage as an example of the direct effect of vaccines on antibiotic resistance and the impact of influenza vaccination on antibiotic usage as an example of a secondary effect. A prelicensure study of a PCV in Africa demonstrated 67% fewer penicillin-resistant invasive disease episodes in the PCV group compared with controls. Similar studies in the United States and Europe demonstrated reductions in antibiotic use consistent with the vaccines’ impact on the risk of otitis media infections in children. Postlicensure reductions in the circulation of antibiotic-resistant strains targeted by the vaccines have been dramatic, with virtual elimination of these strains in children following vaccine introduction. In terms of a secondary effect, following influenza vaccination reductions of 13–50% have been observed in the use of antibiotics by individuals receiving influenza vaccine compared with controls. With the demonstrated effectiveness of vaccination programs in impacting the risk of antibiotic-resistant infections and the increasing threat to public health that these infections represent, more attention needs to be given to development and utilization of vaccines to address antibiotic resistance.

Bacterial Profile of Middle Ear Fluid with Recurrent Acute Otitis Media Infection Using Culture Independent 16S rDNA Gene Sequencing

Background Recurrent otitis media is one of the common infections of childhood. The causative bacterial pathogen is one of the major risk factors of recurrent infection. With limited availability of Indian data, we performed this study to identify the bacterial pathogens. Materials and Methods Otitis media cases were diagnosed based on clinical criteria. Thirty-six middle ear fluid (MEF) samples were collected by tympanocentesis and cultured for pathogens. Seventy-eight per cent of the cases had three previous episodes of otitis media in the past 6 months; the remaining 22% had four episodes in the preceding 6 months. At the time of sample collection, all patients were on antibiotic coverage. Genomic DNA was extracted from MEF samples using Qiagen DNA mini Kit. The 16s rDNA polymerase chain reaction (PCR) and quantitative multiplex (qmPCR) for Streptococcus pneumoniae was performed on these samples. Streptococcus pneumoniae–positive samples were serotyped using PCRSeqTyping. Results None of the 36 samples showed growth by conventional culture. The 16s rDNA PCR identified bacterial pathogens in 33 samples. Four samples gave mixed reads. The organisms identified were Neisseria spp. other than Neisseria meningitidis (n = 7), N. meningitidis (n = 8), Lactococcus spp. (n = 5), S. pneumoniae (n = 2), Pseudomonas aeruginosa (n = 2), Haemophilus influenzae (n = 1), Salmonella infantis (n = 1), Staphylococcus epidermidis (n = 1), Staphylococcus auricularis (n = 1), and Streptococcus sp. (n = 1). The qmPCR detected the presence of S. pneumoniae in six samples. PCRSeqTyping was able to identify Serotype 19A in two samples positive for S. pneumoniae. Conclusion The study demonstrates the usefulness of 16s rDNA PCR protocol to identify the bacterial pathogens in MEF by a culture-independent method. Neisseria spp. were the predominant species identified followed by Lactococcus spp. and S. pneumoniae. Detection of pneumococci by 16s rDNA PCR correlated well with qmPCR-based detection and PCRSeqTyping.

Otitis media, antibiotics, and risk of autism spectrum disorder.

Otitis media infections and antibiotic treatment have been linked to the risk of developing autism spectrum disorder. Broad-spectrum antibiotics may alter the composition of the gut flora microbiota, which is hypothesized to be involved in the regulation of the immune system. This study examines the interplay among otitis media, antibiotics, and the subsequent risk of developing autism. Based on the entire Danish population, 780,547 children were followed from birth (January 1, 1997 to December 31, 2008) until December 31, 2012. We calculated adjusted hazard ratios and absolute risks of autism with 95% confidence intervals (CIs) related to previous otitis media diagnoses and antibiotic prescriptions redeemed at Danish pharmacies. The absolute risk of autism before age 10 was increased among children with otitis media (1.2% for females and 3.3% for males) and in children who had redeemed an antibiotic prescription (0.6% and 2.7% for females and males) compared to children without a history of otitis media and antibiotics usage (0.4% for females and 1.9% for males). Similarly, we found an increased hazard ratio of autism associated with otitis media (1.83 95% CI 1.71-1.95) and antibiotics usage (1.29 95% CI 1.17-1.43). A history of both otitis media and antibiotic treatment did not further increase the risk of autism. Although the risk of autism was associated with otitis media and treatment with antibiotics, we found little evidence of a synergistic effect between otitis media infections and treatment with antibiotics. Autism Res 2018, 11: 1432-1440. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We investigated whether otitis media ear infections and antibiotic treatment were associated with autism spectrum disorder. Autism was more common in children who had had an otitis media infection or who had been treated with antibiotics. Given the observational nature of our data, our study cannot be used to conclude that otitis media or use of antibiotics cause autism, as our findings may be subject to unobserved confounding.

Shewanella algae in a chronic suppurative otitis media patient with cholesteatoma

We present Shewanella algea infection in a chronic suppurative otitis media (CSOM) patient with cholesteatoma in terms of clinical course and treatment. This is the first time S. algea is found as solely pathogen in a CSOM patient without history of contact with seawater in Turkey. The patient admitted to the hospital several times with complaints of otorrhoea, was diagnosed as otitis media and treated. He was hospitalized to the otorhinolaryngology department for further evaluation of recurrent infections. The patient was diagnosed as cholesteatoma according to computed tomography scan findings and was operated for cholesteatoma. As a result of surgical and medical treatment he was discharged with full recovery. Physicians must be aware of rarely seen pathogens and their unexpected ways of transmission and underlying causes such as cholesteatoma when treating patients for CSOM.

Factors affecting the outcome of adenoidectomy in children treated for chronic otitis media with effusion

ObjectiveThe aim of this cohort was to determine potential risk factors, concerning the effectiveness of adenoidectomy in the treatment of chronic otitis media with effusion in children. MethodsNinety six children with chronic otitis media with effusion treated with adenoidectomy were enrolled in this study. A thorough medical history was taken, including family history of otologic disease, parental smoking habits and breast feeding history. Radiographic palatal airway size was measured preoperatively, whereas the presence of allergy was also investigated. All patients were, postoperatively, followed up for a period of two years, in three month intervals. Disease course was classified as “complete remission”, “improvement” or “consistence”, in every postoperative evaluation, according to strictly established criteria. ResultsChildren’s age proved to be a significant factor in the postoperative outcome of adenoidectomy, as a treatment of chronic otitis media with effusion, especially when comparing patients being over and under the fifth year of age. Also, the presence of allergy, family history of otologic disease and palatal airway size, all proved to influence postoperative outcome in a statistical significant way (p<0.05). On the other hand, child’s sex, passive smoking, breast feeding and previous acute otitis media infections did not seem to alter the efficacy of adenoidectomy. ConclusionAdenoidectomy remains a cornerstone in the treatment of chronic otitis media with effusion in children. Results document that young age, presence of allergy predisposition, otologic family history and small palatal airway can be important drawbacks and should be intensively sought for and taken into account, during treatment planning.

Modeling specific antibody responses to natural immunization to predict a correlate of protection against infection before commencing a clinical vaccine trial

ABSTRACT Background Clinical trials of vaccines for children to prevent acute otitis media (AOM) infections caused by the bacteria Streptococcus pneumonia (Spn) are in Phase I. The objective of this study was to use serum antibody measurements to pneumococcal purified protein candidate antigens that occurred after natural “immunization” to predict a correlate of protection response needed following an injectable vaccine against AOM in children. Methods 590 nasal and serum samples were collected from 129 healthy children at 6, 9, 12, 15, 18, 24 and 30–36 months of age and when the child developed AOM. Middle ear fluid to detect Spn was collected at every episode of AOM. Quantitative ELISA was used to determine serum IgG against 7 Spn vaccine antigens: PspA clade 3, PspA clade 5, PhtD, PhtE, LytB, PcpA and Ply. A correlate of protection (COP) was estimated by regressing AOM events against age adjusted antibody levels induced by nasopharyngeal colonization and AOM infections, using logistic regression and generalized estimating equation methods. Results A significant COP was found for Spn PhtD (p = 0.0015), PhtE (p = 0.00034), LytB (p = 0.004), PcpA (p = 0.002), and Ply (p = 0.007) between higher antibody levels and reduced frequency of AOM. We estimated that a 2-fold higher antibody level in a child than the mean antibody level induced by NP colonization (after adjusting for subject age) to PhtD, LytB, PcpA, PhtE or Ply reduced the risk of AOM by 14–21%, a 4-fold higher level reduced it by 25–38% and a 10-fold higher level reduced it by 39–54%. Conclusion We developed a model to predict the necessary level of serum antibody and fold higher above a threshold to PhtD, PhtE, LytB, PcpA and Ply that would correlate with a reduced likelihood of AOM in children age 6–24 months old if enrolled in a Phase III clinical efficacy trial.

Genetic identification of Opr I and Opr L Genes in Pseudomonas aeruginosa isolated from different local sources.

P.aeruginosa bacteria are opportunistic pathogens capable of infection almost every tissue in the body as a result of possessing a large variety of virulence factors which significantly contribute to the pathogenicity of the host events. In the current study was to collect 119 samples from different clinical and environmental sources. to investigate the spread of bacteria P.aeruginosa and to study the virulence factors by a sample of 90 of those patients in several Hospitals in the city of Baghdad, including 33 samples of burns infections, 22 samples of wound infections, 17 samples of Otitis media infections, and 11 samples for urinary tract infections as well as 7 isolates belonging to patients with cystic fibrosis, The environmental samples included 10 samples of soil, 10 samples of water, and 9 samples of theaters. Diagnosed develop isolated after planted on different growth media through phenotypic traits and microscopic examinations and confirmed diagnosis using API 20E kit, as well as molecular diagnostics definitive diagnosis of isolates that give a positive result as bacteria P.aeruginosa during the previous tests were depending on the gene diagnosis 16SrDNA with a special bacterial sequence of P.aeruginosa. Diagnostic results showed that 61 isolated a 51% belonging for the type of P.aeruginosa of the total clinical and environmental samples that were divided on 15 isolates 24.6% of cases of burns infections, 13 isolates 21.4% of cases of wound infections, 10 isolates 16.3% of cases of Otitis media infections, 5 isolates 8.3% of cystic fibrosis, 4 isolates 6.5% of cases of urinary tract infections, 6 isolates 9.8% of soil, 4 isolates 6.5% of water, and 4 isolates 6.5% of the galleries operations. The results of the phenotypic detections of some virulence factors showed that 95% of the isolates were producing hemolysin enzyme type β –hemolysis, while it was 93.44% of the isolates producing protease enzyme and to varying degrees, and the percentage of isolates producing pyocyanin pigment was 73.13%. The prevalence of some virulence factors of P.aeruginosa was investigated in both clinical and environmental isolates by molecular genetic methods, included these genes each of the genes encoded of fatty proteins Opr I, Opr L. The results showed the existence of genes ( Opr I ) increased by 100%, while the gene Opr L ratio was 96.72% within the genetic structure of the isolates studied.

Mastoiditis, Brain Abscess and Sinus Thrombosis As Complications of Chronic Otitis Media: A Case Report

Introduction: Brain abscess is a rare life-threatening focal intracerebral infection. The etiology of brain abscess depends on trauma, surgical intervention, and infection type. In this report, we present a case with brain abscess caused by Prevotella denticola after chronic otitis media infection. Case Presentation: A 27-year-old male patient presented a history of yellowish green ear drainage coloring his pillow for 10 years. One month before admission, he began to suffer from increased headache. He was first admitted to another hospital and treated with ceftriaxone for otitis media. He was referred to our hospital when a brain abscess was detected in cerebral magnetic resonance imaging (MRI). Meropenem and vancomycin treatment was stated empirically because of failure of the previous antibiotic therapy. The abscess was drained through a burr hole on the second day of admission. The aerobic culture of the pus resulted negative; however, black pigmented colonies were detected on anaerobic culture plates. The organism was identified as P. denticola via molecular typing targeting the 16S RNA gene. The postoperative period was complicated by left temporal hematoma that required surgical intervention; left transverse and sigmoid sinuses thrombosis were treated with enoxaparine. Because of the critical condition of the patient, de-escalation was not considered, and the patient received meropenem plus vancomycin for 6 weeks until discharge with complete cure. Conclusions: In conclusion, in spite of usually benign features, chronic otitis media may lead to serious complications such as brain abscess. Every effort should be made for microbiological diagnosis of the causative pathogen(s) for appropriate antibiotic treatment.

Modeling Specific Antibody Responses to Natural Immunization to Predict a Correlate of Protection Against Infection Before Commencing a Clinical Vaccine Trial

ABSTRACTBackground: Clinical trials of vaccines for children to prevent acute otitis media (AOM) infections caused by the bacteria Streptococcus pneumonia (Spn) are in Phase I. The objective of this study was to use serum antibody measurements to pneumococcal purified protein candidate antigens that occurred after natural “immunization” to predict a correlate of protection response needed following an injectable vaccine against AOM in children.Methods: 590 nasal and serum samples were collected from 129 healthy children at 6, 9, 12, 15, 18, 24 and 30–36 months of age and when the child developed AOM. Middle ear fluid to detect Spn was collected at every episode of AOM. Quantitative ELISA was used to determine serum IgG against 7 Spn vaccine antigens: PspA clade 3, PspA clade 5, PhtD, PhtE, LytB, PcpA and Ply. A correlate of protection (COP) was estimated by regressing AOM events against age adjusted antibody levels induced by nasopharyngeal colonization and AOM infections, using logistic regression and ge...

Three Serum Cytokine Biomarkers Predict Presence of Acute Otitis Media Infection and Recovery From Relevant Otopathogens

Three Serum Cytokine Biomarkers Predict Presence of Acute Otitis Media Infection and Recovery From Relevant Otopathogens

Changes in Antibiotic Resistance in Recurrent Pseudomonas Aeruginosa Infections of Chronic Suppurative Otitis Media

This study investigated the changes in antibiotic resistance in recurrent Pseudomonas aeruginosa infections in chronic suppurative otitis media (CSOM). Its aim was to provide a treatment strategy for P aeruginosa infections in CSOM for the prevention of multidrug resistance. A case-control study was conducted in tertiary teaching hospitals in Korea. The experimental group included patients with recurrent P aeruginosa infection who had relapsed within 2 months after the successful control of a previous P aeruginosa infection. The control group consisted of patients with a P aeruginosa infection who had no history of such an infection. An antibiotic sensitivity test was performed for each culture. The proportion of recurrent P aeruginosa infection was 22.69% (98 of 432 cases). Drug resistance to amikacin, tobramycin, netilmicin, ciprofloxacin, and levofloxacin was significantly changed after recurrent infection. The fluoroquinolone strains seen in recurrent P aeruginosa showed high cross-resistance to other drugs. Antibiotic resistance of P aeruginosa in CSOM changed with recurrent infection.