Bacterial findings in middle ear effusion in children.
During 1983-87, tympanostomy tubes were inserted in a total of 4952 ears of 2575 children remitted to the ENT Department of our hospital because of chronic or recurrent otitis media problems. The children were included in a prospective study and referred to one of three groups for comparison of findings. Group 1 included all 6- to 12-month-old infants undergoing primary tube treatment; group 2, all children 1 year or older who had their first ventilation tube(s) inserted in connection with adenoidectomy; and group 3, all children in whom tympanostomy had been performed one or more times previously. Middle ear effusion was aspirated from 2392 ears (48%); 67.6% of all ears were negative for bacteria and 22.1% of the ears with effusion grew pathogenic bacteria. S. pneumoniae was the most frequently cultured pathogen among the 6 to 12 month olds in group 1, but in groups 2 and 3 H. influenzae occurred more frequently than S. pneumoniae. Beta-lactamase-producing strains of pathogenic bacteria were formed in only 4% of all ears with effusion: H. influenzae in 1.2% and B. catarrhalis in 2.8%. Compared with figures from the United states, the frequency of beta-lactamase-producing strains is low in the present series. This is probably explained by differences in antimicrobial treatment practices; in Finland and the Scandinavian countries, penicillin V is the primary drug for acute otitis media. In light of present results, it seems well-suited for treatment of otitis media in young children.
Qvarnberg
Y
Y
Department of Otolaryngology, Central Hospital, Jyväskylä, Finland.
Kantola
O
O
Valtonen
H
H
Vuori
E
E
Salo
J
J
Toivanen
M
M
D000208:Acute Disease; D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008876:Middle Ear Ventilation; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D010033:Otitis Media / Q000382:microbiology / Q000601:surgery; D010034:Otitis Media with Effusion / Q000382:microbiology* / Q000601:surgery; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D001618:beta-Lactamases / Q000096:biosynthesis
D001618:beta-Lactamases