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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2012

Open Access 01-12-2012 | Research article

Non-capsulated and capsulated Haemophilus influenzaein children with acute otitis media in Venezuela: a prospective epidemiological study

Authors: Laura Naranjo, Jose Antonio Suarez, Rodrigo DeAntonio, Francis Sanchez, Alberto Calvo, Enza Spadola, Nicolás Rodríguez, Omaira Andrade, Francisca Bertuglia, Nelly Márquez, Maria Mercedes Castrejon, Eduardo Ortega-Barria, Romulo E Colindres

Published in: BMC Infectious Diseases | Issue 1/2012

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Abstract

Background

Non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae are major causes of bacterial acute otitis media (AOM). Data regarding AOM are limited in Latin America. This is the first active surveillance in a private setting in Venezuela to characterize the bacterial etiology of AOM in children < 5 years of age.

Methods

Between December 2008 and December 2009, 91 AOM episodes (including sporadic, recurrent and treatment failures) were studied in 87 children enrolled into a medical center in Caracas, Venezuela. Middle ear fluid samples were collected either by tympanocentesis or spontaneous otorrhea swab sampling method. Standard laboratory and microbiological techniques were used to identify bacteria and test for antimicrobial resistance. The results were interpreted according to Clinical Laboratory Standards Institute (CLSI) 2009 for non-meningitis isolates. All statistical analyses were performed using SAS 9.1 and Microsoft Excel (for graphical purposes).

Results

Overall, bacteria were cultured from 69.2% (63 of the 91 episodes); at least one pathogen (S. pneumoniae, H. influenzae, S. pyogenes or M. catarrhalis) was cultured from 65.9% (60/91) of episodes. H. influenzae (55.5%; 35/63 episodes) and S. pneumoniae (34.9%; 22/63 episodes) were the most frequently reported bacteria. Among H. influenzae isolates, 62.9% (22/35 episodes) were non-capsulated (NTHi) and 31.4% (11/35 episodes) were capsulated including types d, a, c and f, across all age groups. Low antibiotic resistance for H. influenzae was observed to amoxicillin/ampicillin (5.7%; 2/35 samples). NTHi was isolated in four of the six H. influenzae positive samples (66.7%) from recurrent episodes.

Conclusions

We found H. influenzae and S. pneumoniae to be the main pathogens causing AOM in Venezuela. Pneumococcal conjugate vaccines with efficacy against these bacterial pathogens may have the potential to maximize protection against AOM.
Appendix
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Metadata
Title
Non-capsulated and capsulated Haemophilus influenzaein children with acute otitis media in Venezuela: a prospective epidemiological study
Authors
Laura Naranjo
Jose Antonio Suarez
Rodrigo DeAntonio
Francis Sanchez
Alberto Calvo
Enza Spadola
Nicolás Rodríguez
Omaira Andrade
Francisca Bertuglia
Nelly Márquez
Maria Mercedes Castrejon
Eduardo Ortega-Barria
Romulo E Colindres
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2012
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-12-40

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