Nasopharyngeal carriage of Streptococcus pneumoniae at the completion of successful antibiotic treatment of acute otitis media predisposes to early clinical recurrence.
OBJECTIVE
We sought to investigate the role of Streptococcus pneumoniae (SP) nasopharyngeal (NP) colonization after successful antibiotic treatment (Rx) of acute otitis media (AOM) in recurrent AOM (RAOM).


METHODS
NP cultures were obtained from 494 (93%) of 530 patients at the end of antibiotic treatment (EOT).


RESULTS
At enrollment, middle ear fluid (MEF) cultures in 418 (79%) of 530 patients were positive for pathogens. At EOT, NP cultures in 208 (42%) of 494 patients were positive for SP. RAOM was found in 130 (26%) of 494 patients: 66 (32%) of 208 with SP-positive NP and 64 of 286 (22%) without SP-positive NP at EOT (P=.026). MEF was positive for SP during RAOM in 34 (61%) of 56 patients with SP-positive NP and 17 (36%) of 47 patients without SP-positive NP at EOT (P=.022). The same serotype was identified in 24 (80%) of 30 SP pairs; complete identity was found between isolates in 22 (96%) of 23 SP pairs.


CONCLUSIONS
Early RAOM was more commonly caused by SP if the organism was present in NP at EOT during the initial AOM episode. Most SP-RAOM episodes were caused by SP isolates present in NP at EOT during the previous AOM episode.
Libson
Shai
S
Pediatric Infectious Disease Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Dagan
Ron
R
Greenberg
David
D
Porat
Nurith
N
Trepler
Ronit
R
Leiberman
Alberto
A
Leibovitz
Eugene
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002353:Carrier State; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009305:Nasopharynx / Q000382:microbiology*; D010033:Otitis Media / Q000188:drug therapy* / Q000382:microbiology; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000382:microbiology*; D012008:Recurrence
D000900:Anti-Bacterial Agents