Raluca Horhat1,2,3, Florin-Raul Horhat4, Valeria Mocanu5,6. 1. Department of Functional Sciences, Biophysics, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Timisoara, Romania. 2. Clinic of Paediatric Surgery (Otolaryngology Department), Emergency Children's Hospital Louis Turcanu, Timisoara, Romania. 3. Center for Modeling Biological Systems and Data Analysis, "Victor Babeş" University of Medicine and Pharmacy, Timisoara, Romania. 4. Department of Functional Sciences, Medical Informatics and Biostatistics, "Victor Babeș" University of Medicine and Pharmacy, Timisoara, Romania. 5. Department of Surgery, Ophthalmology, "Victor Babeș" University of Medicine and Pharmacy, Timisoara, Romania. 6. Clinic of Paediatric Surgery, Emergency Children's Hospital Louis Turcanu, Timisoara, Romania.
Abstract
OBJECTIVES: Streptococcus pneumoniae is the leading bacterial etiologic agent in acute otitis media (AOM), and it produces a more severe inflammatory response than other otopathogens. Additionally, the presence of multidrug-resistant (MDR) S. pneumoniae is an important issue in the management of AOM. The present pilot study aimed to ascertain whether MDR S. pneumoniae is associated with a higher inflammatory response and/or a more severe disease. METHODS: This was a prospective, single-center study on nonpneumococcal conjugate vaccine-immunized pediatric patients with severe AOM. Demographic and clinical characteristics were recorded. Middle ear fluid was obtained and cultured for each patient; antibiotic-resistance profiling was tested for S. pneumoniae isolates. The C-reactive protein (CRP) level and complete blood count were determined. Patients with positive middle ear fluid culture for S. pneumoniae were divided into 2 groups according to antibiotic resistance profile: MDR and non-MDR. RESULTS: MDR S. pneumoniae was identified in 15 (35.7%) of the 42 eligible patients. Children in this group had significantly higher CRP levels (72.23 ± 62.92 vs. 14.96 ± 15.57 mg/L, p < 0.001), higher absolute neutrophil count (8.46 ± 3.97 vs. 5.22 ± 4.5 × 103/mm3, p = 0.004), higher percentage of neutrophils (52.85 ± 13.49% vs. 38.34 ± 16.16%, p = 0.004), and were more prone to develop acute mastoiditis (p = 0.01). Receiver operating characteristic analysis identified CRP as the best biomarker to discriminate between the 2 groups of patients (AUC = 0.891). CONCLUSION: MDR S. pneumoniae was associated with a more severe inflammatory response and a higher incidence of mastoiditis.
OBJECTIVES: Streptococcus pneumoniae is the leading bacterial etiologic agent in acute otitis media (AOM), and it produces a more severe inflammatory response than other otopathogens. Additionally, the presence of multidrug-resistant (MDR) S. pneumoniae is an important issue in the management of AOM. The present pilot study aimed to ascertain whether MDR S. pneumoniae is associated with a higher inflammatory response and/or a more severe disease. METHODS: This was a prospective, single-center study on nonpneumococcal conjugate vaccine-immunized pediatric patients with severe AOM. Demographic and clinical characteristics were recorded. Middle ear fluid was obtained and cultured for each patient; antibiotic-resistance profiling was tested for S. pneumoniae isolates. The C-reactive protein (CRP) level and complete blood count were determined. Patients with positive middle ear fluid culture for S. pneumoniae were divided into 2 groups according to antibiotic resistance profile: MDR and non-MDR. RESULTS: MDR S. pneumoniae was identified in 15 (35.7%) of the 42 eligible patients. Children in this group had significantly higher CRP levels (72.23 ± 62.92 vs. 14.96 ± 15.57 mg/L, p < 0.001), higher absolute neutrophil count (8.46 ± 3.97 vs. 5.22 ± 4.5 × 103/mm3, p = 0.004), higher percentage of neutrophils (52.85 ± 13.49% vs. 38.34 ± 16.16%, p = 0.004), and were more prone to develop acute mastoiditis (p = 0.01). Receiver operating characteristic analysis identified CRP as the best biomarker to discriminate between the 2 groups of patients (AUC = 0.891). CONCLUSION: MDR S. pneumoniae was associated with a more severe inflammatory response and a higher incidence of mastoiditis.
Authors: Allan S Lieberthal; Aaron E Carroll; Tasnee Chonmaitree; Theodore G Ganiats; Alejandro Hoberman; Mary Anne Jackson; Mark D Joffe; Donald T Miller; Richard M Rosenfeld; Xavier D Sevilla; Richard H Schwartz; Pauline A Thomas; David E Tunkel Journal: Pediatrics Date: 2013-02-25 Impact factor: 7.124
Authors: Abdelazeem M Algammal; Mahmoud Mabrok; Elayaraja Sivaramasamy; Fatma M Youssef; Mona H Atwa; Ali W El-Kholy; Helal F Hetta; Wael N Hozzein Journal: Sci Rep Date: 2020-09-29 Impact factor: 4.379