Incidence Survey of Acute Otitis Media in Children in Sado Island, Japan—Sado Otitis Media Study (SADOMS)

Abstract

BackgroundAcute otitis media (AOM) is one of the most common forms of bacterial infection and cause for clinic visits in children. The incidence of AOM was 0.9–1.2 episodes per person-year during the first 2 years of life in previous reports conducted before 2000. The aim of this study was to 1) evaluate the latest AOM incidence in pediatric outpatients and 2) identify the bacterial pathogens from these patients and ascertain their serotypes and resistance.MethodsThe study was conducted in a closed population, involving all pediatricians and otolaryngologists in Sado Island allowing accurate determination of AOM incidence. In each month, one week was assigned as “surveillance week”, and all outpatients with acute illness aged 0–18 years examined during the surveillance weeks were enrolled. AOM was diagnosed on the basis of otoscopic findings and clinical symptoms were recorded. Specimens were collected from the nasopharynx or middle ear cavity of AOM patients and examined for bacteria. Antimicrobial susceptibilities, serotypes, and molecular typing for resistance were determined among Streptococcus pneumoniae and Haemophilus influenzae. ResultsIn total, 8,283 clinic visits were conducted, and 354 episodes (4.3%, 95% CI: 3.9–4.7%) among 312 children were diagnosed as AOM. The incidence of AOM was highest in children of 1 year of age (0.54 episodes/child/year, 95% CI: 0.44–0.64). Serotype coverage of 7- and 13-valent pneumococcal conjugate vaccines in this study were 38.0% (95% CI: 29.3–47.3) and 62.8% (95% CI: 53.6–71.4), respectively. Of 122 H.influenzae isolates available for typing, 120 were nontypeable and 2 were type b. A high proportion of S. pneumoniae isolates (46%) showed resistance to penicillin. Approximately half of H. influenzae isolates had genetic markers for beta-lactamase-negative ampicillin-resistance.ConclusionsApproximately 4–5% of pediatric outpatients, even without AOM-related symptoms, had AOM in our study. Pediatricians as well as otolaryngologists should check the tympanic membrane findings of all pediatric outpatients.

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“…AOM is one of the most common forms of bacterial infection in children, with an incidence of 0.5 to 1.2 episodes per person-year during the first 2 years of life (5). AOM imposes a large burden on both children and their parents, with 13 million episodes annually and an annual cost of more than $3 billion in U.S. children aged 0 to 4 years (6).…”

The biofilm‐associated bacterial infections unrelated to indwelling devices

“…Otitis media is a standard clinical terminology, which includes acute otitis media, chronic otitis media, and chronic otitis media with effusion, also referred to as nonsuppurative otitis media . Chronic otitis media is associated with chronic suppurative otitis media but is different from it as chronic otitis media is not necessarily a result of pus accumulation Haemophilus influenzae , Streptococcus pneumoniae , and Moraxella catarrhalis , have been collected from up to 25% of infants with otitis media, and molecular approaches have confirmed DNA of these bacteria in up to 80% of all cases …”

Antimicrobial activity of antisense peptide–peptide nucleic acid conjugates against non-typeableHaemophilus influenzaein planktonic and biofilm forms

“…1 The incidence of acute otitis media is 0.5 -1.2 episodes per person-year during the first 2 years of life. 2 Since the introduction of the pneumococcal conjugate vaccines, a shift of otopathogens in otitis media has been observed. Instead of Streptococcus pneumoniae, NTHi has been the leading cause of acute otitis media (30% -65%) and the most common otopathogen detected from middle ear fluids of children with otitis media with effusion (20%-30%).…”