Korean J Pediatr Infect Dis.  2000 Nov;7(2):233-239. 10.14776/kjpid.2000.7.2.233.

The Causative Organisms of Otitis Media Accompanying Otorrhea in Children and Their Antimicrobial Susceptibility

• Jung DS
• Kim HS
• Park CW
• Oh SH

• KMID: 2440223
• DOI: http://doi.org/10.14776/kjpid.2000.7.2.233

Abstract

PURPOSE
A great deal of youngsters suffer from otitis media, for which antimicrobials are frequently prescribed. Increased antimicrobial resistance forces physicians to judiciously use antimicrobial agents in treating patients with acute otitis media. There have however been few references with regard to otitis media in Korean children, and authors proceeded investigation to look for the causative agents of otitis media in Korean children and their antimicrobial susceptibility.
METHODS
The study included 65 patients younger than 15 years old who had been cared at the department of pediatrics and otolaryngology in Hanyang University Hospital from July 1994 to June 1999, and diagnosed of otitis media with otorrhea which contained microorganisms isolated in otorrhea culture. The medical records were reviewed for demographic data, isolated organisms and their antimicrobial susceptibility.
RESULTS
Among 65 patients, 37(57%) were boys and 28(43%) girls. Distribution of the patients was reciprocal to the age of the patients; 27 patients(41.5%) were younger than 1 year old, 24(36.9%) were 1 to 3 years old with the average of 2.9 years of age. Staphylococus aureus was isolated in 32 patients(49.2%), Streptococcus pneumoniae in 19 patients(29.2 %) Haemophilus inf luenzae in 9 patients(13.8%), Streptococcus oralis in 3 patients(4.6%), Moraxella catarrhalis in 1 patient(1.5%). The isolated microorganisms were not different whether patients had cleft lip/palate or not. The antibiotic resistance rates of S. aureus were ≥90% to erythromycin, imipenem, cephalothin, and clindamycin, 86.2% to oxacillin, 25% to chloramphenicol, 12.5% to trimethoprim/sulfamethoxazole(TMP/SMX), and 0% to vancomycin and teicoplanin. The antibiotic resistance rates of S. pneumoniae were 71.4% to penicillin and greater than 60% to erythromycin, tetracycline, TMP/SMX, 7.1% to chloramphenicol, and 0% to vancomycin and teicoplanin. The antibiotic resistance rates of H. influenzae were 55% to ampicillin and TMP/SMX, and 0% to chloramphenicol, ceftriaxone, aztreonam, imipenem and ciprofloxacin.
CONCLUSION
With otorrhea culture, the causative organisms of otitis media appear to be S. aureus, S. pneumoniae and H. influenzae. The high antibiotic resistance rates of the isolated organisms should affect the choice of antibiotics in treating patients with otitis media. Prospective investigations utilizing tympanocentesis in microbiologic studies are needed.

Keyword

Otitis media; Antibiotic resistance; Streptococcus pneumoniae; Haemophilus influenzae; Moraxella catarrhalis

MeSH Terms

Ampicillin
Anti-Bacterial Agents
Anti-Infective Agents
Aztreonam
Ceftriaxone
Cephalothin
Child*
Chloramphenicol
Ciprofloxacin
Clindamycin
Drug Resistance, Microbial
Erythromycin
Female
Haemophilus
Haemophilus influenzae
Humans
Imipenem
Influenza, Human
Medical Records
Moraxella (Branhamella) catarrhalis
Otitis Media*
Otitis*
Otolaryngology
Oxacillin
Pediatrics
Penicillins
Pneumonia
Prospective Studies
Streptococcus oralis
Streptococcus pneumoniae
Teicoplanin
Tetracycline
Tympanocentesis
Vancomycin
Ampicillin
Anti-Bacterial Agents
Anti-Infective Agents
Aztreonam
Ceftriaxone
Cephalothin
Chloramphenicol
Ciprofloxacin
Clindamycin
Erythromycin
Imipenem
Oxacillin
Penicillins
Teicoplanin
Tetracycline
Vancomycin