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Methicillin-resistant Staphylococcus aureus in acute otitis externa

World Journal of Otorhinolaryngology-Head and Neck Surgery 2018年第4期4卷 246-252页

作者： Maria J.duarte elliott d.kozin Paulo J.M.Bispo Andreas H.Mitchell Michael S.Gilmore Aaron K.Remenschneider department of Otology and Laryngology Harvard Medical SchoolBostonMAUSA department of Otolaryngology Massachusetts Eye and Ear InfirmaryBostonMAUSA department of Ophthalmology Harvard Medical SchoolMassachusetts Eye and Ear InfirmaryBostonMAUSA department of Microbiology Harvard Medical SchoolMassachusetts Eye and Ear InfirmaryBostonMAUSA department of Immunobiology Harvard Medical SchoolMassachusetts Eye and Ear InfirmaryBostonMAUSA University of Massachusetts Medical School WorcesterMAUSA

Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be *** goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa(AOE).Study design:Retrospective review of an institutional microbiologic ***:A retrospective analysis was performedon serial culture isolates taken fromthe ear at a quaternary care hospital from January 2014 to April *** causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration(MIC)*** records were reviewed to document patient characteristics,chronicity of infection,symptomatology,and previous ***:Over the study period,173 patients were diagnosed with AOE and underwent otologic cultures of the ***-three(30.6%)of cultures grew ***(SA).Of SA infections,15(28.3%)were identified as *** patients were typically older than patients with methicillin-sensitive SA(MSSA)(mean age 46.717.9 vs 2919.4,PZ0.003)and had more medical comorbidities(4 vs 1.7,PZ0.001).Compared to patients with MSSA,patients with MRSAwere significantly more likely to have had prior ototopical antibiotic exposure(37%vs 73%,PZ0.019).Conclusion:Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the *** should consider ear cultures to identify MRSA *** of Evidence:IV.

关键词： Acute otitis externa Staphylococcus aureus Methicillin-resistant Staphylococcus aureus,MRSA

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Improvement in word recognition following treatment failure for sudden sensorineural hearing loss

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第3期2卷 -页

作者： Taha A. Jan elliott d. kozin Vivek V. Kanumuri Rosh K. Sethi david H. Jung department of 0tolaryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA 02114 USA

Objectives:Patients with sudden sensorineural hearing loss (SSNHL) may have word recognition scores (WRS) that correlate with pure tone average (PTA). We hypothesize that there is a subset of patients with SSNHL who have improved WRS despite stable PTA. Methods:Retrospective case review at a tertiary otolaryngology practice. Results:We identified 13 of 113 patients with SSNHL whose WRS increased despite overall sta-ble pure tone averages. There was an observed average improvement in WRS by 23.8 points in this patient cohort at follow-up, with mean initial PTA in the affected ear at 48.7 dB. Conclusions: We identify a novel cohort of SSNHL patients that have failed treatment as measured by PTA, but who have increased WRS over time. These data have implications for patient counseling and lend insight into the pathophysiology of SSNHL.

关键词： Sensorineural hearing loss Sudden sensorineural hearing loss Word recognition score Pure tone average

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