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Correlation of nasopharyngeal cultures prior to and at onset of acute otitis media with middle ear fluid cultures.

Kaur R, Czup K, Casey JR, Pichichero ME - BMC Infect. Dis. (2014)

Bottom Line: During healthy visits, S. pneumoniae (Spn) was isolated from 656 (31.7%) NP cultures compared to 253 (12.2%) for Nontypeable Haemophilus influenzae (NTHi) and 723 (34.9%) for Moraxella catarrhalis (Mcat).At 530 AOM visits, Spn was isolated from 152 (28.7%) of MEF compared to 196 (37.0%) for NTHi and 104 (19.6%) for Mcat.For epidemiology purposes, antibiotic susceptibility of MEF isolates can be predicted by NP culture results when samples are collected at onset of AOM.

View Article: PubMed Central - PubMed

Affiliation: Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, 14621, Rochester, NY, USA. ravinder.kaur@rochestergeneral.org.

ABSTRACT

Background: We sought to determine if nasopharyngeal (NP) cultures taken at times of healthy visits or at onset of acute otitis media (AOM) could predict the otopathogen mix and antibiotic-susceptibility of middle ear isolates as determined by middle ear fluid (MEF) cultures obtained by tympanocentesis.

Methods: During a 7-year-prospective study of 619 children from Jun 2006-Aug 2013, NP cultures were obtained from 6-30 month olds at healthy visits and NP and MEF (by tympanocentesis) at onset of AOM episodes.

Results: 2601 NP and 530 MEF samples were collected. During healthy visits, S. pneumoniae (Spn) was isolated from 656 (31.7%) NP cultures compared to 253 (12.2%) for Nontypeable Haemophilus influenzae (NTHi) and 723 (34.9%) for Moraxella catarrhalis (Mcat). At onset of AOM 256 (48.3%) of 530 NP samples were culture positive for Spn, 223 (42%) for NTHi and 251 (47.4%) for Mcat, alone or in combinations. At 530 AOM visits, Spn was isolated from 152 (28.7%) of MEF compared to 196 (37.0%) for NTHi and 104 (19.6%) for Mcat. NP cultures collected at onset of AOM but not when children were healthy had predictive value for epidemiologic antibiotic susceptibility pattern assessments.

Conclusions: NP cultures at onset of AOM more closely correlate with otopathogen mix than NP cultures at healthy visits using MEF culture as the gold standard, but the correlation was too low to allow NP cultures to be recommended as a substitute for MEF culture. For epidemiology purposes, antibiotic susceptibility of MEF isolates can be predicted by NP culture results when samples are collected at onset of AOM.

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Distribution ofS. pneumoniae, NTHiandM. catarrhalisbacteria at 6, 9, 12, 15, 18 and 24 months of age during healthy colonization and their presence in MEF during AOM. The healthy colonization of each bacteria increased significantly with age but no significant difference was observed with age during AOM. A negative trend with age was observed for S. pneumoniae in MEF during AOM shown by dotted line in the figure.
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Fig1: Distribution ofS. pneumoniae, NTHiandM. catarrhalisbacteria at 6, 9, 12, 15, 18 and 24 months of age during healthy colonization and their presence in MEF during AOM. The healthy colonization of each bacteria increased significantly with age but no significant difference was observed with age during AOM. A negative trend with age was observed for S. pneumoniae in MEF during AOM shown by dotted line in the figure.

Mentions: The presence of Spn, NTHi and Mcat in the NP (Figure 1A) and their presence in MEF during AOM (Figure 1B) were compared according to the age of the child. During healthy visits NP colonization by potential otopathogens significantly increased with age (p <0.05, with correlation r2 = 0.7880 for Spn, 0.931 for NTHi and 0.729 for Mcat). During AOM, the otopathogens in the MEF between 6-24 months of age did not show any age specific distribution. A negative trend with age was observed for Spn (p = 0.06 and r2 = 0.617) but NTHi and Mcat were uniformly distributed between 6-24 months of age.Figure 1


Correlation of nasopharyngeal cultures prior to and at onset of acute otitis media with middle ear fluid cultures.

Kaur R, Czup K, Casey JR, Pichichero ME - BMC Infect. Dis. (2014)

Distribution ofS. pneumoniae, NTHiandM. catarrhalisbacteria at 6, 9, 12, 15, 18 and 24 months of age during healthy colonization and their presence in MEF during AOM. The healthy colonization of each bacteria increased significantly with age but no significant difference was observed with age during AOM. A negative trend with age was observed for S. pneumoniae in MEF during AOM shown by dotted line in the figure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4264249&req=5

Fig1: Distribution ofS. pneumoniae, NTHiandM. catarrhalisbacteria at 6, 9, 12, 15, 18 and 24 months of age during healthy colonization and their presence in MEF during AOM. The healthy colonization of each bacteria increased significantly with age but no significant difference was observed with age during AOM. A negative trend with age was observed for S. pneumoniae in MEF during AOM shown by dotted line in the figure.
Mentions: The presence of Spn, NTHi and Mcat in the NP (Figure 1A) and their presence in MEF during AOM (Figure 1B) were compared according to the age of the child. During healthy visits NP colonization by potential otopathogens significantly increased with age (p <0.05, with correlation r2 = 0.7880 for Spn, 0.931 for NTHi and 0.729 for Mcat). During AOM, the otopathogens in the MEF between 6-24 months of age did not show any age specific distribution. A negative trend with age was observed for Spn (p = 0.06 and r2 = 0.617) but NTHi and Mcat were uniformly distributed between 6-24 months of age.Figure 1

Bottom Line: During healthy visits, S. pneumoniae (Spn) was isolated from 656 (31.7%) NP cultures compared to 253 (12.2%) for Nontypeable Haemophilus influenzae (NTHi) and 723 (34.9%) for Moraxella catarrhalis (Mcat).At 530 AOM visits, Spn was isolated from 152 (28.7%) of MEF compared to 196 (37.0%) for NTHi and 104 (19.6%) for Mcat.For epidemiology purposes, antibiotic susceptibility of MEF isolates can be predicted by NP culture results when samples are collected at onset of AOM.

View Article: PubMed Central - PubMed

Affiliation: Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, 14621, Rochester, NY, USA. ravinder.kaur@rochestergeneral.org.

ABSTRACT

Background: We sought to determine if nasopharyngeal (NP) cultures taken at times of healthy visits or at onset of acute otitis media (AOM) could predict the otopathogen mix and antibiotic-susceptibility of middle ear isolates as determined by middle ear fluid (MEF) cultures obtained by tympanocentesis.

Methods: During a 7-year-prospective study of 619 children from Jun 2006-Aug 2013, NP cultures were obtained from 6-30 month olds at healthy visits and NP and MEF (by tympanocentesis) at onset of AOM episodes.

Results: 2601 NP and 530 MEF samples were collected. During healthy visits, S. pneumoniae (Spn) was isolated from 656 (31.7%) NP cultures compared to 253 (12.2%) for Nontypeable Haemophilus influenzae (NTHi) and 723 (34.9%) for Moraxella catarrhalis (Mcat). At onset of AOM 256 (48.3%) of 530 NP samples were culture positive for Spn, 223 (42%) for NTHi and 251 (47.4%) for Mcat, alone or in combinations. At 530 AOM visits, Spn was isolated from 152 (28.7%) of MEF compared to 196 (37.0%) for NTHi and 104 (19.6%) for Mcat. NP cultures collected at onset of AOM but not when children were healthy had predictive value for epidemiologic antibiotic susceptibility pattern assessments.

Conclusions: NP cultures at onset of AOM more closely correlate with otopathogen mix than NP cultures at healthy visits using MEF culture as the gold standard, but the correlation was too low to allow NP cultures to be recommended as a substitute for MEF culture. For epidemiology purposes, antibiotic susceptibility of MEF isolates can be predicted by NP culture results when samples are collected at onset of AOM.

Show MeSH
Related in: MedlinePlus