Evaluation of nasopharyngeal cultures for bacteriologic assessment of acute otitis media in children

Géhanno, P.; Lenoir, G.; Barry, B.; Bons, Jacques; Boucot, I.; Berche, Patrick

doi:10.1097/00006454-199604000-00009

Cited by 78 publications

(39 citation statements)

References 6 publications

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“…The negative predictive value (likelihood that bacteria not found in the nasopharynx are not AOM pathogens) ranges from 95% to 99% for all 3 bacteria. 188,189 Therefore, if nasopharyngeal culture is negative for specific bacteria, that organism is likely not the AOM pathogen. A negative culture for S pneumoniae, for example, will help eliminate the concern for multidrugresistant bacteria and the need for unconventional therapies, such as levofloxacin or linezolid.…”

Section: Initial Antibiotic Treatment Failurementioning

confidence: 99%

The Diagnosis and Management of Acute Otitis Media

Tunkel

Rosenfeld²,

Sevilla³

et al. 2013

Pediatrics

1,089

832

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This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM.In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations.The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships.The practice guideline underwent comprehensive peer review before formal approval by the AAP.This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem. Pediatrics 2013;131:e964-e999

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Section: Initial Antibiotic Treatment Failurementioning

confidence: 99%

The Diagnosis and Management of Acute Otitis Media

Tunkel

Rosenfeld²,

Sevilla³

et al. 2013

Pediatrics

1,089

832

View full text Add to dashboard Cite

show abstract

“…Carriage of bacteria partly correlates with middle ear findings during acute otitis media [7]. The result of nasopharyngeal culture has an excellent negative predictive value [8]. Thus, if a pathogen is not detected in the nasopharynx, it is most likely not a cause of acute otitis media.…”

Section: Introductionmentioning

confidence: 99%

Detection of Streptococcus pneumoniae carriage by the Binax NOW test with nasal and nasopharyngeal swabs in young children

Vuorenoja

Jalava

Lindholm

et al. 2011

Eur J Clin Microbiol Infect Dis

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The rapid detection of carriage of Streptococcus pneumoniae could assist in the management of pneumococcal infection, such as acute otitis media. We evaluated the reliability of the Binax NOW test in the exclusion and detection of pneumococcal carriage by nasal samples from 139 children and using nasopharyngeal samples from 250 children (aged 6-35 months) with respiratory infection with or without acute otitis media. The Binax NOW test results were compared with culture-based detection of carriage of S. pneumoniae. The Binax NOW test from the nasal samples had a sensitivity of 95%, a specificity of 78%, and the positive and negative predictive values were 83 and 93%, respectively; and for the nasopharyngeal samples the corresponding numbers were 88%, 95%, 96%, and 87%. When rapid knowledge of the carriage status of S. pneumoniae is needed, the Binax NOW test is a reliable method for the exclusion of carriage using nasal sampling, and in the detection of carriage using nasopharyngeal sampling.

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“…Simultaneous cultures from nasopharynx and middle ear samples from patients with AOM demonstrate the same pathogen in a high proportion of cases (1)(2)(3)(4)(5)9). This study was designed to determine the reliability of a rapid pneumococcal antigen test in detecting the presence or absence of S. pneumoniae in the nasopharynxes of children with or without AOM.…”

mentioning

confidence: 99%

New Technique (the NOW Test) for Rapid Detection of Streptococcus pneumoniae in the Nasopharynx

et al. 2002

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Although the NOW test was originally introduced as a rapid pneumococcal antigen detection test for use with urine samples, it was successfully adapted to nasopharyngeal samples in the present study. The sensitivity, specificity, positive predictive value, and negative predictive value of the test were 92.2, 97.7, 95.9, and 95.5%, respectively. These results demonstrate that nasopharyngeal colonization with Streptococcus pneumoniae can be documented within 15 min of sample collection.Streptococcus pneumoniae is the leading bacterial cause of respiratory infections in children and of acute otitis media (AOM) in particular (8). Simultaneous cultures from nasopharynx and middle ear samples from patients with AOM demonstrate the same pathogen in a high proportion of cases (1)(2)(3)(4)(5)9). This study was designed to determine the reliability of a rapid pneumococcal antigen test in detecting the presence or absence of S. pneumoniae in the nasopharynxes of children with or without AOM.Children below the age of 15 years were enrolled at three office sites after we obtained informed consent. The enrollees had to be either healthy or ill with AOM. The children were enrolled without regard to sex or race. Children were excluded from the study if they had been treated with antibiotics within the past month. Nasopharyngeal samples were obtained with Mini-tip Culturettes (Becton Dickinson, Sparks, Md.). The specimens were cultured within 12 h of collection. The specimens were cultured on sheep blood agar and chocolate agar. The plates were incubated at 36°C in 5% CO 2 for 18 to 24 h. S. pneumoniae was identified by colonial morphology, Gram stain characteristics, optochin sensitivity, and bile solubility. Nontypeable Haemophilus influenzae was identified by growth on chocolate agar, colonial morphology, Gram strain characteristics, a growth requirement for X and V factors, and failure to agglutinate with typing antisera. Moraxella catarrhalis was identified by colonial morphology, Gram stain characteristics, and the biochemical reaction of butyrate esterase.The NOW test was obtained from Binex, Inc., Portland, Maine. It is an in vitro rapid immunochromatographic assay for the detection of S. pneumoniae cell wall polysaccharide in urine specimens from patients with symptoms of pneumonia. The test kit incorporates rabbit anti-S. pneumoniae antibody adsorbed onto a nitrocellulose membrane. If pneumococcal cell wall polysaccharide is in the specimen, an easily discernible pink-to-purple line appears within 15 min on the membrane. A control is included to ensure the validity of the test. We adapted the test to detect pneumococcal antigen in the nasopharynxes of children colonized with S. pneumoniae. The same swab used to collect the sample for culture was used for the NOW test. The procedure was conducted according to the directions in the kit. The sensitivity, specificity, positive predictive value, and negative predictive value of the NOW test were calculated for the total population and for the healthy and AOM subpopulations a...

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Evaluation of nasopharyngeal cultures for bacteriologic assessment of acute otitis media in children

Cited by 78 publications

References 6 publications

The Diagnosis and Management of Acute Otitis Media

The Diagnosis and Management of Acute Otitis Media

Detection of Streptococcus pneumoniae carriage by the Binax NOW test with nasal and nasopharyngeal swabs in young children

New Technique (the NOW Test) for Rapid Detection of Streptococcus pneumoniae in the Nasopharynx

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