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

authors:

avatar arezoo asadi , avatar mahdi gudarzi , avatar meh gou ORCID , * , avatar hamidreza houri , avatar nasrin ebrahimi , avatar tina delsoz bahri

Koomesh: Vol.17, issue 4; 814-820
published online: September 28, 2016
article type: Research Article
received: January 02, 2015
accepted: December 03, 2015

how to cite: asadi A, gudarzi M, gou M, houri H, ebrahimi N, et al. Investigating the frequency and resistance to treatment of Streptococcus pneumoniaeis in patients with otitis. koomesh. 2016;17(4):e151172. 

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.

References

  • 1.

    Gribben B, Salkeld LJ, Hoare S, Jones HF. The incidence of acute otitis media in New Zealand children under five years of age in the primary care setting. J Prim Health Care 2012; 4: 205-212.

  • 2.

    Klein JO. The epidemiology of pneumococcal disease in infants and children. Rev Infect Dis 1981; 3: 246-253.

  • 3.

    Leibovitz E, Jacobs MR, Dagan R. Haemophilus influenzae: a significant pathogen in acute otitis media. The Pediatr Infect Dis J 2004; 23: 1142-1152.

  • 4.

    Leskinen K, Hendolin P, Virolainen-Julkunen A, Ylikoski J, Jero J. The clinical role of Alloiococcus otitidis in otitis media with effusion. Int J Pediatr Otorhinolaryngol 2002; 66: 41-48.

  • 5.

    Worrall G. Acute otitis media. Can Fam Physician 2007; 53: 2147.

  • 6.

    Rubins JB, Janoff EN. Pneumolysin: a multifunctional pneumococcal virulence factor. J Lab Clin Med 1998; 131: 21-27.

  • 7.

    Geoffroy C, Gaillard JL, Alouf JE, Berche P. Purification, characterization, and toxicity of the sulfhydryl-activated hemolysin listeriolysin O from Listeria monocytogenes. Infect Immun 1987; 55: 1641-1646.

  • 8.

    Bravo L. Overview of the disease burden of invasive pneumococcal disease in Asia. Vaccine 2009; 27: 7282-7291.

  • 9.

    Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. The Lancet 2010; 375: 1969-1987.

  • 10.

    Brueggemann AB, Griffiths DT, Meats E, Peto T, Crook DW, Spratt BG. Clonal relationships between invasive and carriage Streptococcus pneumoniae and serotype-and clone-specific differences in invasive disease potential. J Infect Dis 2003; 187: 1424-1432.

  • 11.

    Watt JP, Wolfson LJ, O'Brien KL, Henkle E, Deloria-Knoll M, McCall N, et al. Burden of disease caused by< i> Haemophilus influenzae type b in children younger than 5 years: global estimates. The Lancet 2009; 374: 903-911.

  • 12.

    Dallal MM, Jabbari H, Forushani AR, Heidarzadeh S, Afrogh P, Yazdi MK. Frequency and Resistance Patterns of Streptococcus Pneumoniae in Acute Otitis Media. J Mazandaran Univ Med Sci 2013; 22 (Persian).

  • 13.

    Bakhshaei M, Ghazvini K, Naderi H, Zamanian A, Haghighi J, Boghrabadian M. The prevalence of nasopharyngeal streptococcal pneumonia carriers in Mashhad day care children and their antibiotic resistance pattern. Iranian J Otorhinol 2006; 18: 119-126.

  • 14.

    Khoramrooz SS, Mirsalehian A, Emaneini M, Jabalameli F, Aligholi M, Saedi B, et al. Frequency of Alloicoccus otitidis, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae in children with otitis media with effusion (OME) in Iranian patients. Auris Nasus Larynx 2012; 39: 369-373.

  • 15.

    Khoramrooz SS, Mirsalehian A, Imaneini H, Jabalameli F, Sharifi A, Aligholi M, et al. Characterization of< i> Alloiococcus otitidis strains isolated from children with otitis media with effusion by Pulsed-Field Gel Electrophoresis. Intern J Pediatric Otorhinol 2012; 76: 1658-1660.

  • 16.

    Greve T, Mller JK. Accuracy of using the lytA gene to distinguish Streptococcus pneumoniae from related species. J Med Microbiol 2012; 61: 478-482.

  • 17.

    Doern GV, Brueggemann A, Holley HP, Rauch AM. Antimicrobial resistance of Streptococcus pneumoniae recovered from outpatients in the United States during the winter months of 1994 to 1995: results of a 30-center national surveillance study. Antimicrob Agents Chemother 1996; 40: 1208-1213.

  • 18.

    Qvarnberg Y, Kantola O, Salo J, Toivanen M, Valtonen H, Vuori E. Influence of topical steroid treatment on maxillary sinusitis. Rhinology 1992; 30: 103-112.

  • 19.

    Sahni RS, Paparella MM, Schachern PA, Goycoolea MV, Le CT. Thickness of the human round window membrane in different forms of otitis media. Arch Otolaryngol Head Neck Surg 1987; 113: 630-634.

  • 20.

    Chatrchyan S, Hmayakyan G, Khachatryan V, Sirunyan A, Adam W, Bauer T, et al. The CMS experiment at the CERN LHC. J Instrument 2008; 3: S08004.

  • 21.

    Maria da Gloria SC, Tondella ML, McCaustland K, Weidlich L, McGee L, Mayer LW, Steigerwalt A, et al. Evaluation and improvement of real-time PCR assays targeting lytA, ply, and psaA genes for detection of pneumococcal DNA. J Clin Microbiol 2007; 45: 2460-2466.

  • 22.

    Seki M, Yamashita Y, Torigoe H, Tsuda H, Sato S, Maeno M. Loop-mediated isothermal amplification method targeting the lytA gene for detection of Streptococcus pneumoniae. J Clin Microbiol 2005; 43: 1581-1586.

  • 23.

    Verhelst R, Kaijalainen T, De Baere T, Verschraegen G, Claeys G, Van Simaey L, et al. Comparison of five genotypic techniques for identification of optochin-resistant pneumococcus-like isolates. J Clin Microbiol 2003; 41: 3521-3525.

  • 24.

    Pellegrini S, Gonzalez Macchi ME, Sommerfleck PA, Bernldez PC. Intratemporal complications from acute otitis media in children: 17 cases in two years. Acta Otorrinolaringologica (English Edition) 2012; 63: 21-25.

  • 25.

    Aydn EG, Tel E, Kaplan A, Aydn A. Equilibrium and pre-equilibrium calculations of neutron production in mediumheavy targets irradiated by protons up to 100MeV. Ann Nuclear Energy 2008; 35: 2306-2312.

  • 26.

    Bos JC, Beishuizen SJ, Madeira GC, dos Gomonda E, Cossa EO, Macome AC, et al. Antimicrobial susceptibility of Streptococcus pneumoniae in adult patients with pneumococcal pneumonia in an urban hospital in Mozambique. BMC Res Note 2014; 7: 110.

  • 27.

    Caraway N, Hawkins E, Hinds D, Mason E. Penicillin susceptibility of Streptococcus pneumoniae in a private pediatric hospital in Houston, Texas. Antimicrob Agents Chemother 1989; 33: 1111-1112.