Resistant Streptococcus Pneumoniae Strains in Children with Acute Otitis Media- High Risk of Persistent Colonization After Treatment
Overview
Authors
Affiliations
Background: Despite advances in the development of pneumococcal conjugate vaccines, acute otitis media (AOM) is a common childhood infection, caused mainly by Streptococcus pneumoniae. It has been suggested that persistence of pneumococcal nasopharyngeal carriage is a risk factor for subsequent recurrent infections.
Methods: In this study we evaluate the relationship between 55 pneumococcal strains obtained from nasopharynx/oropharynx (NP/OP) and middle ear fluid (MEF) of 62 children, aged between 1 and 16 years, during AOM (including recurrent/treatment failure AOM, and post-treatment visits), based on their phenotypic and genotypic characteristics performed by analyses of serotype, antibiotic susceptibility patterns and multilocus sequence typing.
Results: S.pneumoniae was isolated from 27.4% of MEF samples; it constituted 43.6% of all positive bacterial samples from MEF samples. There was statistically significant concordance between isolation from the MEF sample and NP/OP colonization by S. pneumoniae (p < 0.0001). During post-treatment visits S.pneumoniae was isolated from 20.8% of children; 91% of them were positive in pneumococcal NP/OP culture during AOM. The serotypes belonging to 10- and 13-valent pneumococcal conjugated vaccines constituted 84% and 92% of the strains, respectively. Multidrug resistance was found in 84% of the strains. According to multivariate analysis, pneumococcal colonization after antibiotic therapy was significantly associated with shorter length of therapy in children with bilateral AOM.
Conclusions: High persistent prevalence of antibiotic-resistant S.pneumoniae strains in children with AOM after unsuccessful bacterial eradication may presumably be regarded as a predisposing factor of infection recurrence.
Ricci Conesa H, Skroder H, Norton N, Bencina G, Tsoumani E PLoS One. 2024; 19(4):e0297098.
PMID: 38564583 PMC: 10986968. DOI: 10.1371/journal.pone.0297098.
Kielbik K, Grywalska E, Glowniak A, Mielnik-Niedzielska G, Korona-Glowniak I Int J Mol Sci. 2023; 24(9).
PMID: 37175589 PMC: 10178342. DOI: 10.3390/ijms24097883.
Amino Acid Starvation-Induced Glutamine Accumulation Enhances Pneumococcal Survival.
Zhang C, Liu Y, An H, Wang X, Xu L, Deng H mSphere. 2023; 8(3):e0062522.
PMID: 37017541 PMC: 10286718. DOI: 10.1128/msphere.00625-22.
Brennhofer S, Rogawski McQuade E, Zhang J, Pholwat S, Stroup S, Platts-Mills J Am J Trop Med Hyg. 2022; 108(2):428-432.
PMID: 36535258 PMC: 9896336. DOI: 10.4269/ajtmh.22-0583.
Huang L, Yang M, Huang Y, Jiang K, Yan J, Sun A Front Microbiol. 2022; 13:892364.
PMID: 35722327 PMC: 9198556. DOI: 10.3389/fmicb.2022.892364.