MARCHISIO P, GIRONI S, DRAGO L, POZZI G, PASSALI D, OLDONI T, PRINCIPI N; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 491.

Pediatric Dept 4 - Univ. of Milan, Milan, Italy

BACKGROUND: An imbalance in the nasopharynx (NP) between alpha-hemolytic streptococci (AHS) and respiratory pathogens was reported in children with otitis media (OM).The data are limited by unclear definition of the disease and small sample sizes.METHODS: We determined the presence in the NP of respiratory pathogens (St.pneumoniae, H.influenzae, M. catarrhalis) and AHS in 248 children with OM (mean age 2.9 years, range 6 m-7 yrs) (112 OME, effusion >/= 3 months without recent acute OM, 82 rAOM, >/= 3 episodes of acute OM in 6 months; 54 acute OM) and in 55 age-matched controls without middle ear problems. No antibiotic had been given in the previous 4 weeks. A semiquantitative analysis was employed in the reading of NP plates.RESULTS: Respiratory pathogens colonized more frequently children with OM than controls (151/248, 60.9% vs 18/55,32.7%, p= 0.003; OME: 67.2%,rAOM 47.6%, AOM 66.7%). AHS was isolated more frequently in controls (18/55, 32.7%) than in children with OM (65/248, 26.1%). According to types of otitis media, AHS was present in 34.5% of OME,14.6% of rAOM (p=0.02 vs healthy) and 25.9% of AOM. Heavy load of AHS was found in 66.7% of OME, 41.7% of rAOM (p=0.04 vs healthy), 57.1% of AOM and 83.3% of controls. The ratio between AHS and respiratory pathogens was lower in children with OM (total OM: 0.36, OME: 0.46,rAOM 0.23,AOM 0.36) compared to healthy children (0.74).CONCLUSIONS: The balance between respiratory pathogens and AHS is disturbed differently in children with different types of OM. Lesser concentrations of AHS seem to be associated with AOM (either isolate or recurrent) while higher and heavier NP carriage of AHS seems to counterbalance the presence of NP respiratory pathogens in children with chronic OME, thus preventing acute infections.KEYWORDS: Alpha-hemolytic streptococci; Children; Otitis media

Publication Types:

• Meeting Abstracts

Keywords:

• Acute Disease
• Anti-Bacterial Agents
• Case-Control Studies
• Child
• Haemophilus influenzae
• Humans
• Nasopharynx
• Otitis Media
• Pneumococcal Vaccines
• Recurrence
• Streptococcus
• Streptococcus pneumoniae

Other ID:

• GWAIDS0009416

UI: 102246914

From Meeting Abstracts