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[Etiology of acute otitis media in a children's hospital and antibiotic sensitivity of the bacteria involved].

BACKGROUND
This study provides an update on the bacterial etiology of acute otitis media in our area, the antibiotic sensitivity of the bacteria implicated in this condition, and the prevalence of circulating Streptococcus pneumoniae serotypes.


METHODS
Results from a total of 240 samples obtained by diagnostic tympanocentesis and 167 samples of spontaneous otorrhea processed between 1999 and 2001 were reviewed retrospectively.


RESULTS
The mean age of the patients studied was 17 months and the median was 13 months (range: 1 month-7 years). Among the tympanocentesis samples, S. pneumoniae was recovered from 67 (27.9%), Haemophilus influenzae from 60 (25%), both S. pneumoniae and H. influenzae from 3 (1.3%) and Moraxella catarrhalis from 6 (2.5%). Among the spontaneous otorrhea samples, S. pneumoniae was recovered from 15 (9%), H. influenzae from 25 (15%) and both S. pneumoniae and H. influenzae from 1 (0.6%). The remaining samples showed either no growth or recovery of colonizing flora. The main findings were as follows: 49.3% of S. pneumoniae strains showed intermediate sensitivity to penicillin (MIC: 0.12-1 microg/ml), 16.9% were resistant to penicillin (MIC: > or = 2 microg/ml) and 54% were resistant to macrolides; 24,7% of H. influenzae and 100% of M. catarrhalis strains were beta-lactamase producers; and 64 (84.2%) of 76 S. pneumoniae serotyped strains belonged to pneumococcal heptavalent vaccine serotypes.


CONCLUSIONS
S. pneumoniae and H. influenzae were the main causal agents of acute otitis media. Antibiotic sensitivity of the bacteria involved showed the same characteristics as the general pattern in our country. Spontaneous otorrhea culture was not a useful method for establishing the etiology of acute otitis media. Knowledge of the distribution of S. pneumoniae serotypes is essential for assessing epidemiological changes resulting from the use of heptavalent pneumococcal vaccine.