Methicillin-resistant Staphylococcus aureus otorrhea after tympanostomy tube placement.
OBJECTIVE
To compare a retrospective cohort of nonhospitalized children with methicillin-resistant Staphylococcus aureus (MRSA) otorrhea with those with methicillin-sensitive S aureus (MSSA) otorrhea to determine the risk factors predisposing to MRSA otorrhea and the treatments used.


METHODS
Retrospective case-controlled series.


METHODS
Tertiary pediatric care facility.


METHODS
Seventeen children with MRSA otorrhea after bilateral myringotomy with tympanostomy tube insertion (BM&T) and 19 age- and sex-matched control subjects who demonstrated MSSA otorrhea. The average age at culture in MRSA patients was 52 months; in MSSA patients, 54 months. There were 8 boys and 3 girls in the MRSA group and 8 boys and 4 girls in the MSSA group.


METHODS
Oral, topical, and intravenous antimicrobial agents.


METHODS
Antibiotic exposure and history of otitis media and routine antibiotic administration (topical, oral, or intravenous).


RESULTS
The following findings were statistically significant (P < or = .06, Mann-Whitney test): (1) longer duration of antibiotic treatment after BM&T for patients with MRSA vs those with MSSA; (2) increased number of episodes of acute otitis media before BM&T in patients with MRSA vs those with MSSA; and (3) increased number of courses of antibiotics after BM&T in patients with MRSA vs those with MSSA.


CONCLUSIONS
Methicillin-resistant S aureus otorrhea is commonly seen as a community-acquired infection in otherwise healthy pediatric outpatients. Risk factors for development of MRSA otorrhea include the number of episodes of acute otitis media before BM&T and number of treatment courses and duration of antibiotic therapy after BM&T.
Coticchia
James M
JM
Department of Otolaryngology, Wayne State University School of Medicine, Detroit, Mich, USA.
Dohar
Joseph E
JE
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008876:Middle Ear Ventilation / Q000009:adverse effects*; D010033:Otitis Media / Q000382:microbiology*; D012189:Retrospective Studies; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus / Q000187:drug effects*
D000900:Anti-Bacterial Agents