title: What are the leading causative pathogens in acute otitis media with tympanic membrane perforation?
abstract: OBJECTIVE
  Acute otitis media (AOM) is a common infectious disease in children. Data regarding the distribution of causative pathogens are not universal. Tympanic perforation due to AOM may occur in 5-30% of AOM patients. The causative pathogens for AOM with tympanic perforation are limited.
  
  
  METHODS
  This was a prospective study conducted at the Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Thailand. All consecutive children diagnosed as having AOM with tympanic perforation were enrolled. The age of the eligible patients was between 3 months and 5 years. Pus from the middle ear of each patient was swabbed and tested for culture/sensitivity.
  
  
  RESULTS
  There were 40 eligible patients diagnosed with AOM with tympanic perforation in this study. The mean age of all patients was 24.3 months and the patients were predominantly male (26 male; 65.0%). None of these patients received S. pneumoniae or H. influenzae vaccination. All specimens were culture positive (100%) and 13 organisms were identified. There were 53 identified pathogens; the most common pathogen was H. influenzae (19 times or 35.8%), followed by Staphylococcus aureus (14 times or 26.4%). H. influenzae was 100% sensitive to chloramphenicol, amoxicilllin/clavulanic acid, cefotaxime, and ciprofloxacin, while S. aureus was also 100% sensitive to oxacillin, vancomycin, and fusidic acid.
  
  
  CONCLUSIONS
  The two most common pathogens for AOM with tympanic perforation were H. influenzae and Staphylococcus aureus. Both pathogens were mostly sensitive to antibiotics.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
authors.forename: Nuntigar
authors.initials: N
authors.lastname: Sonsuwan
authors.affiliation: Kamphaeng Phet Hospital, Kamphaeng Phet, Thailand.
authors.forename: Patcharin
authors.initials: P
authors.lastname: Watcharinyanon
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Research Center in Back, Neck Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen 40002, Thailand; Internal Medicine Research Group, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. Electronic address: kittisak@kku.ac.th.
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D010033:Otitis Media / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011550:Pseudomonas aeruginosa; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013297:Streptococcus pyogenes; D013785:Thailand / Q000453:epidemiology; D018058:Tympanic Membrane Perforation / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute otitis media; Culture; Pathogens; Sensitivity; Tympanic perforation