title: Streptococcus pneumoniae Serotypes and Antibiotic Susceptibility Patterns in Middle Ear Fluid Isolates During Acute Otitis Media and Nasopharyngeal Isolates During Community-acquired Alveolar Pneumonia in Central Romania.
abstract: Streptococcus pneumoniae is a common cause of community-acquired alveolar pneumonia (CAAP) and acute otitis media (AOM) in children. Romania has high rates of S. pneumoniae antibiotic resistance. The pneumococcal conjugated vaccines (PCVs) are not being used routinely in this country. The aims of the study were as follows: 1) to compare pneumococcal antibiotic resistance patterns in AOM and CAAP in children from central Romania and 2) to compare differences in the distribution of pneumococcal serotypes isolated from the middle ear fluid (MEF) of children with AOM and from the nasopharynx (NP) of children with CAAP.
  
  
  
  Children younger than 5 years old with AOM or with radiologically confirmed CAAP were prospectively enrolled. Samples from MEF and NP were evaluated for antibiotic susceptibility and serotyping.
  
  
  
  Eighty-eight children with CAAP and 68 with AOM were enrolled. Of the MEF and CAAP isolates, 64 (94.1%) and 79 (89.7%) were penicillin nonsusceptible, respectively. The pneumococcal serotypes distribution in AOM was similar to those in CAAP except for serotype 19F, which was more common in AOM. Overall, 89.7% and 85.8% of all serotypes in AOM and CAAP patients, respectively, were covered by 13-valent PCV.
  
  
  
  MEF and NP-CAAP S. pneumoniae isolates were similar in regard to serotype distribution and antibiotic resistance. S. pneumoniae antibiotic resistance rates were extremely high. Thirteen-valent PCV has the potential to reduce both the burden of disease as well as the rates of antibiotic-resistant S. pneumoniae in both diseases.
authors: From the *Department of Pediatrics, Children's Clinic Hospital, Faculty of Medicine, and †Department of Neurology, County Emergency Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania; ‡Pediatric Infectious Disease Unit, Soroka University Medical Center, and §Pediatric Infectious Disease Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors: Raluca-Ileana
authors: RI
authors: Lixandru
authors: Cristian
authors: C
authors: Falup-Pecurariu
authors: Laura
authors: L
authors: Bleotu
authors: Alice
authors: A
authors: Mercas
authors: Eugene
authors: E
authors: Leibovitz
authors: Ron
authors: R
authors: Dagan
authors: David
authors: D
authors: Greenberg
authors: Oana
authors: O
authors: Falup-Pecurariu
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology*; D010033:Otitis Media / Q000382:microbiology*; D011018:Pneumonia, Pneumococcal / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents