Nasopharyngeal Carriage ofStreptococcus pneumoniaeat the Completion of Successful Antibiotic Treatment of Acute Otitis Media Predisposes to Early Clinical Recurrence

Shai Libson, Ron Dagan, David Greenberg, Nurith Porat, Ronit Trepler, Alberto Leiberman, Eugene Leibovitz
2005 Journal of Infectious Diseases  
Objective. We sought to investigate the role of Streptococcus pneumoniae (SP) nasopharyngeal (NP) colonization after successful antibiotic treatment (Rx) of acute otitis media (AOM) in recurrent AOM (RAOM). Patients and methods. NP cultures were obtained from 494 (93%) of 530 patients at the end of antibiotic treatment (EOT). Results. At enrollment, middle ear fluid (MEF) cultures in 418 (79%) of 530 patients were positive for pathogens. At EOT, NP cultures in 208 (42%) of 494 patients were
more » ... 4 patients were positive for SP. RAOM was found in 130 (26%) of 494 patients: 66 (32%) of 208 with SP-positive NP and 64 of 286 (22%) without SP-positive NP at EOT ( ). MEF was positive for SP during RAOM in 34 (61%) of 56 patients with SP-positive NP and 17 (36%) P p .026 of 47 patients without SP-positive NP at EOT ( ). The same serotype was identified in 24 (80%) of 30 P p .022 SP pairs; complete identity was found between isolates in 22 (96%) of 23 SP pairs. Conclusions. Early RAOM was more commonly caused by SP if the organism was present in NP at EOT during the initial AOM episode. Most SP-RAOM episodes were caused by SP isolates present in NP at EOT during the previous AOM episode.
doi:10.1086/429918 pmid:15871120 fatcat:kwagghrhybckxoaze72xvhsrby