Background: The microbiology of acute otitis media has changed in the heptavalent pneumococcal conjugate vaccine (PCV) era. We hypothesize similar changes with pediatric mastoiditis.

Objectives: To compare the etiology of mastoiditis in the pre-PCV (January 1995-December 2000) and post-PCV (January 2001- April 2005) eras to guide empiric antimicrobial therapy in the pediatric emergency department.

Methods: Retrospective chart review of all patients admitted with a diagnosis of mastoiditis from January 1995 to April 2005.

Results: : One hundred twenty-two charts were reviewed, 68 pre-PCV and 54 post-PCV. Etiological agents were determined by culture results in 60 patients. The most common bacterial isolates were Streptococcus pneumoniae (24), Pseudomonas aeruginosa (12), Staphylococcus aureus (12), Streptococcus pyogenes (8), and Haemophilus influenzae (2). There was no reduction in mastoiditis due to S. pneumoniae from the pre-PCV to the post-PCV eras (odds ratio [OR], 0.9; 95% confidence interval [CI], 0.4-2.1; P = 0.77). Ceftriaxone nonsusceptibility was seen in 30% of post-PCV S. pneumoniae isolates compared with 7% of pre-PCV isolates. Acute mastoiditis was diagnosed in 93 patients, and chronic mastoiditis (defined as >or=3 wk of symptoms) was diagnosed in 29 patients. Streptococcus pneumoniae was more likely to be implicated in acute versus chronic mastoiditis (OR, 9.2; 95% CI, 1.2-52.2; P = 0.01). Pseudomonas aeruginosa was more frequently implicated in chronic versus acute mastoiditis (OR, 16.4; 95% CI, 2.1-75.8; P = 0.0003).

Conclusions: There was no difference in the proportion of pediatric mastoiditis cases caused by S. pneumoniae in the pre-PCV versus post-PCV eras. Empiric antimicrobial therapy with ceftriaxone alone is not sufficient in the post-PCV era.

Download full-text PDF

Source
http://dx.doi.org/10.1097/PEC.0b013e31815a0001DOI Listing

Publication Analysis

Top Keywords

empiric antimicrobial
12
antimicrobial therapy
12
pediatric mastoiditis
8
pneumococcal conjugate
8
conjugate vaccine
8
mastoiditis
8
pre-pcv post-pcv
8
streptococcus pneumoniae
8
pseudomonas aeruginosa
8
pneumoniae pre-pcv
8

Similar Publications

Machine learning and clinician predictions of antibiotic resistance in Enterobacterales bloodstream infections.

J Infect

December 2024

Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Electronic address:

Background: Patients with Gram-negative bloodstream infections are at risk of serious adverse outcomes without active treatment, but identifying who has antimicrobial resistance (AMR) to target empirical treatment is challenging.

Methods: We used XGBoost machine learning models to predict antimicrobial resistance to seven antibiotics in patients with Enterobacterales bloodstream infection. Models were trained using hospital and community data from Oxfordshire, UK, for patients with positive blood cultures between 01-January-2017 and 31-December-2021.

View Article and Find Full Text PDF

is increasingly resistant to antibiotics, significantly lowering eradication rates and posing a major public health challenge. This study investigated the distribution of antibiotic-resistant phenotypes and genotypes of in Hainan Province. It determined the minimum inhibitory concentrations (MICs) of six antibiotics using the E-test method and detected resistance genes via Sanger sequencing.

View Article and Find Full Text PDF

Bacteriological Profile and Antibiogram of Blood Stream Infection in a Tertiary Teaching Hospital of Bangladesh.

Mymensingh Med J

January 2025

Professor Dr Khandaker Abu Talha, Professor, Department of Neurosurgery, Sylhet Women's Medical College (SWMC), Sylhet, Bangladesh; E-mail:

Blood stream infection (BSI) is of the most devastating infection of any hospital which has a high mortality. Staphylococcus aureus, coagulase-negative staphylococci (CONS) and enterococcus species are commonest isolated bacteria. This was a cross-sectional descriptive study conducted at the Sylhet Women's Medical College Hospital from October 2022 to March 2023.

View Article and Find Full Text PDF

Rapid multiplex molecular syndromic panels (RMMSP) (3 or more pathogens and time-to-results < 6 h) allow simultaneous detection of multiple pathogens and genotypic resistance markers. Their implementation has revolutionized the clinical landscape by significantly enhancing diagnostic accuracy and reducing time-to-results in different critical conditions. The current revision is a comprehensive but not systematic review of the literature.

View Article and Find Full Text PDF

Bloodstream Infection Combined with Thoracic Infection Caused by : A Case Report and Review of the Literature.

Infect Drug Resist

December 2024

Department of Laboratory Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, People's Republic of China.

Objective: is usually found in urogenital tract infections and is associated with several extra-genitourinary infections, including septic arthritis, bacteremia, and meningitis. Here, we report a rare case of induced bloodstream infection with thoracic inflammation in a surgical patient.

Methods: A 56-year-old male who underwent surgery for multiple pelvic and rib fractures developed fever, pleural effusion, and wound exudation despite receiving prophylactic anti-infection treatment with cefotiam.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!