title: A prospective, observational, epidemiological evaluation of the aetiology and antimicrobial susceptibility of acute otitis media in Saudi children younger than 5years of age.
abstract: BACKGROUND
  Information regarding acute otitis media (AOM) aetiology is important for developing effective vaccines. Here, bacterial aetiology and antimicrobial susceptibility of AOM were determined in young Saudi children.
  
  
  METHODS
  Children aged 3-60months with a new episode of AOM, who had not received antibiotics or had received antibiotics for 48-72h but remained symptomatic, were enrolled in this prospective, observational, epidemiological study in Riyadh. Middle ear fluid (MEF) samples were collected by tympanocentesis or from spontaneous otorrhea, and tested for the presence of Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes and Moraxella catarrhalis. Antimicrobial susceptibility of the identified pathogens was assessed using E-tests.
  
  
  RESULTS
  Between June 2009 and May 2011, 66 children were enrolled. S. pneumoniae was detected in 6 episodes and non-typeable H. influenzae (NTHi) in 8 episodes. Moreover, Staphylococcus aureus, which is an uncommon cause of AOM, was detected in 17 episodes. Pneumococcal serotypes were 7F (n=2), 23F (n=2), 19F (n=1) and 15F (n=1). Susceptibility to cefotaxime was observed in all pneumococcal and H. influenzae isolates, to cefuroxime in 4/6 pneumococcal and 8/8 H. influenzae isolates, and to penicillin in 5/6 pneumococcal isolates.
  
  
  CONCLUSIONS
  S. pneumoniae and NTHi were major bacterial contributors for AOM in Saudi children.
authors.affiliation: King Saud University and King Saud bin Abdulaziz University for Health Sciences, PO Box 86118, Riyadh, Saudi Arabia. Electronic address: kalmazrou@gmail.com.
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Al-Mazrou
authors.affiliation: King Saud University, PO Box 2457, Riyadh 11451, Saudi Arabia. Electronic address: amshibl@ksu.edu.sa.
authors.forename: Atef M
authors.initials: AM
authors.lastname: Shibl
authors.affiliation: GlaxoSmithKline Vaccines, Avenue Fleming 20, 1300 Wavre, Belgium. Electronic address: walid.x.kandeil@gsk.com.
authors.forename: Walid
authors.initials: W
authors.lastname: Kandeil
authors.affiliation: GlaxoSmithKline Vaccines, Avenue Fleming 20, 1300 Wavre, Belgium. Electronic address: jean-yves.x.pircon@gsk.com.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Pirçon
authors.affiliation: GlaxoSmithKline Vaccines, Avenue Fleming 20, 1300 Wavre, Belgium. Electronic address: cinzia.x.marano@gsk.com.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Marano
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002439:Cefotaxime / Q000494:pharmacology* / Q000627:therapeutic use; D002444:Cefuroxime / Q000494:pharmacology; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000453:epidemiology; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D001936:Moraxella catarrhalis / Q000302:isolation & purification*; D045828:Moraxellaceae Infections / Q000188:drug therapy / Q000453:epidemiology; D010033:Otitis Media / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control / Q000628:therapy*; D010406:Penicillins / Q000494:pharmacology* / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011446:Prospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D017211:Treatment Failure; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D022242:Pneumococcal Vaccines; D002439:Cefotaxime; D002444:Cefuroxime
keywords: Acute otitis media; Antibiotic resistance; Child; Haemophilus influenzae; Saudi Arabia; Streptococcus pneumoniae
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