Investigating the frequency and resistance to treatment of Streptococcus pneumoniaeis in patients with otitis

Abstract

Introduction: Streptococcus pneumoniaeis is the most frequent cause of bacterial meningitis, community-acquired bacterial pneumonia and acute otitis media (AOM). Eighty percent of children have at least once diagnosed by the three years of age. This study was conducted to determine the frequency of patients with Streptococcus pneumoniaein diagnosed with acute middle ear infections and antibiotic susceptibility patterns of this microorganism. Materials and Methods: Middle ear discharge specimens were collected from 60 patients with acute otitis media during a period of 8 months, at Amir Alam Hospital (Tehran). Specimens were assessed for Streptococcus pneumonia by microscopic examination and culture. The antibiotic susceptibility test was performed by Kirby-Bauer disk diffusion method according to CLSI (clinical and laboratory standard institute) criteria. Antibiotics included tetracycline,erythromycin,vancomycin,chloramphenicol, amoxycilinclavulanate,Rifampine, ,ciprofloxacin, Cefixime,Trimethoprim+Sulfa. Identification and confirmation of isolates were performed by PCR and culture. Results: Thirty three/ 60 and 27/60 of specimen were belong to men and women, respectively. Eight/ 60 tested specimens were confirmed as Streptococcus pneumonia. The sensitivity of isolated Streptococcus pneumoniae to different antibiotics was tested and the results were as following: tetracycline (56%), erythromycin (67%), vancomycin (22%), chloramphenicol (56%), and amoxycilin clavulanate (22%), Rifampine (44.4%), ciprofloxacin (56%), Cefixime (100%) Trimethoprim+Sulfa (77.8%). Conclusion: Streptococcus pneumonia is the main cause for AOM. According to the emergence of resistant strains of Streptococcus pneumonia to conventional antibiotic therapy, especially beta-lactam antibiotics and erythromycin, continuous surveillance is needed to determine full picture of antibiotic susceptibility in patients with AOM.