title: Acute Mastoiditis Before Pneumococcal Vaccination: The Experience of a Large Tertiary Care Pediatric Hospital.
abstract: To report the experience of a large tertiary care pediatric center during a period of increasing Streptococcus pneumoniae antimicrobial resistance before the introduction of pneumococcal vaccine in Israel. Retrospective chart review of children diagnosed acute mastoiditis (AM) between January 1997 and December 2007. The children were divided into 4 age groups (6-11, 12-23, 24-35, and 36-40 months), and each group was compared with the others. A total of 198 AM episodes were recorded during the 10-year study period. The most prevalent pathogen was S. pneumonia, with a very low (15%) penicillin resistance rate (minimal inhibitory concentration ≥ 2). Complications were more prevalent in the 12- to 23-month age group. The number of AM cases increased during the study period. Penicillin resistance did not play an important role in determining the morbidity before the introduction of pneumococcal conjugate vaccine.
authors.affiliation: 1Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel; 2Divisions of Pediatric Department, Dana-Dwek Children Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel; 3Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and 4Division of Infectious Disease, Department of Pediatrics, Dana-Dwek Children's Hospital Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel.
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
authors.forename: Sharon
authors.initials: S
authors.lastname: Morag
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Arik
authors.initials: A
authors.lastname: Alper
authors.forename: Shimon
authors.initials: S
authors.lastname: Reif
authors.forename: Galia
authors.initials: G
authors.lastname: Grisaru-Soen
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000008:administration & dosage* / Q000494:pharmacology; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification*; D063128:Tertiary Health Care
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D022242:Pneumococcal Vaccines