title: Genetic characteristics of Haemophilus influenzae and Streptococcus pneumoniae isolated from children with conjunctivitis-otitis media syndrome.
abstract: Acute conjunctivitis is the most common ocular disorders among children and frequently concomitant with acute otitis media (AOM) as conjunctivitis-otitis syndrome. In this study, we evaluated prevalence of causative pathogens and PCR-based genotypes of Haemophilus influenzae and Streptococcus pneumoniae among children with conjunctivitis-otitis media syndrome. Nontypeable H. influenzae (NTHi) is identified most often at 61.8% in conjunctiva exudates followed by S. pneumoniae at 28.2% and Moraxella catarrhalis at 19.1%. Genetic β-lactamase nonproducing ampicillin resistant (gBLNAR) strains of NTHi and genetic penicillin resistant S. pneumoniae (gPRSP) were identified at 72.1% and at 74.2% among conjunctiva isolates by polymerase chain reaction (PCR), respectively. Pneumococcal strains having either ermB or mefE genes were identified at 93.5% among conjunctiva isolates. The restriction fragment of patterns of 89.7% pairs of H. influenzae isolates and 100% pairs of pneumococcal isolates from conjunctiva exudates, middle ear fluids (MEFs) and nasopharyngeal swabs were identical. In contrast to the previous reports, most prevalent strains from conjunctivitis-otitis media syndrome was BLNAR H. influenzae in this study. The causative pathogen responsible for acute conjunctivitis will be originated from the nasopharynx. In the absence of MEFs one can possibly rely on the nasopharyngeal culture to guide an appropriate treatment.
authors: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors: Gen
authors: G
authors: Sugita
authors: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan. Electronic address: mhotomi@wakayama-med.ac.jp.
authors: Muneki
authors: M
authors: Hotomi
authors: Sugita ENT Clinic, Chiba, Japan.
authors: Rinya
authors: R
authors: Sugita
authors: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors: Masamitsu
authors: M
authors: Kono
authors: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors: Akihisa
authors: A
authors: Togawa
authors: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors: Kazuma
authors: K
authors: Yamauchi
authors: Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
authors: Toshinari
authors: T
authors: Funaki
authors: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors: Noboru
authors: N
authors: Yamanaka
mesh_terms: D002675:Child, Preschool; D004432:Ear, Middle / Q000382:microbiology; D005260:Female; D005838:Genotype; D006192:Haemophilus Infections / Q000453:epidemiology / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000235:genetics*; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000382:microbiology; D010033:Otitis Media / Q000453:epidemiology / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000235:genetics*
keywords: Acute bacterial conjunctivitis; Acute otitis media; Acute rhinosinusitis; Haemophilus influenzae; Pulsed-field gel electrophoresis; Streptococcus pneumoniae