title: Antibiotic resistance of Streptococcus pneumoniae in children with acute otitis media treatment failure.
abstract: OBJECTIVE
  The emergence of antibiotic-resistant bacteria is a major cause of treatment failure in children with acute otitis media (AOM). This study aimed to analyze the types of bacterial strains in fluid isolated from the middle ear of children with AOM who did not respond to oral antibiotic treatment. We also determined the antibiotic resistance of the most frequently isolated bacterial strain (Streptococcus pneumoniae) found in these children.
  
  
  METHODS
  This was a prospective study of 157 children with AOM aged from 6 months to 7 years admitted due to unsuccessful oral antibiotic treatment. All children underwent a myringotomy, and samples of the middle ear fluid were collected for bacteriological examination.
  
  
  RESULTS
  Positive bacterial cultures were obtained in 104 patients (66.2%), with Streptococcus pneumoniae (39.69%), Haemophilus influenzae (16.03%) Staphylococcus aureus (16.03%), Staphylococcus haemolyticus (6.9%) and Streptococcus pyogenes (5.34%) found most frequently. The majority (65.4%) of S. pneumoniae strains were penicillin-intermediate-resistant or penicillin-resistant, and 67.2% strains of S. pneumoniae were multidrug-resistant.
  
  
  CONCLUSIONS
  We identified S. pneumoniae as the most frequently isolated pathogen from the middle ear in children with AOM treatment failure and determined that the majority of strains were antibiotic-resistant. We propose that the microbiological identification of bacterial strains and their degree of antibiotic resistance should be performed prior to therapy in order to choose the most appropriate antibiotic therapy for children with AOM treatment failure.
authors.affiliation: ENT Department, Children's Hospital, 4/24 Niekłańska Str. 03-924 Warsaw, Poland. Electronic address: bzielnik@lekarz.net.
authors.forename: Beata
authors.initials: B
authors.lastname: Zielnik-Jurkiewicz
authors.affiliation: ENT Department, Children's Hospital, 4/24 Niekłańska Str. 03-924 Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Bielicka
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006192:Haemophilus Infections / Q000150:complications / Q000188:drug therapy*; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D041162:Staphylococcus haemolyticus / Q000302:isolation & purification*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute otitis media; Antibiotic resistance; Children; Streptococcus pneumoniae