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Can non-typeable Haemophilus influenzae carriage surveillance data infer antimicrobial resistance associated with otitis media?

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Pediatric Investigation 2023年第1期7卷 13-22页

作者： Sophia Bowman-Derrick Tegan M.Harris Jemima Beissbarth Mariana Kleinecke Katrina Lawrence Teresa M.Wozniak Amy Bleakley Angela Rumaseb Michael J.Binks Robyn L.Marsh Peter S.Morris Amanda J.Leach Heidi Smith-Vaughan Menzies School of Health Research Charles Darwin UniversityDarwinAustralia Australian e-Health Research Centre CSIRO BrisbaneAustralia Royal Darwin Hospital DarwinAustralia

Importance:In remote communities of the Northern Territory,Australia,children experience high rates of otitis media(OM),commonly caused by non-typeable Haemophilus influenzae(NTHi).Few data exist on antibiotic susceptibility of NTHi from OM.Objective:To determine whether population-level nasopharyngeal NTHi antibiotic susceptibility data could inform antibiotic treatment for OM.Methods:NTHi isolates(n=92)collected from ear discharge between 2003 and 2013 were selected to time-and age-match NTHi isolates from the nasopharyngeal carriage(n=95).Antimicrobial susceptibility were tested.Phylogenomic trees and a genome-wide association study(GWAS)were performed to determine the similarity of nasopharyngeal and ear isolates at a population level.Results:Among 174 NTHi isolates available for antimicrobial susceptibility testing,10.3%(18/174)were resistant to ampicillin and 9.2%(16/174)were resistant to trimethoprim-sulfamethoxazole.Small numbers of isolates(≤3)were resistant to tetracycline,chloramphenicol,or amoxicillin-clavulanic acid.There was no statistical difference in the proportion of ampicillin-resistant(P=0.11)or trimethoprim-sulfamethoxazole-resistant isolates(P=0.70)between ear discharge and nasopharynx-derived NTHi isolates.Three multi-drug resistant NTHi isolates were identified.Phylogenomic trees showed no clustering of 187 Haemophilus influenzae isolates based on anatomical niche(nasopharynx or ear discharge),and no genetic variations that distinguished NTHi derived from ear discharge and nasopharyngeal carriage were evident in the GWAS.Interpretation:In this population-level study,nasopharyngeal and ear discharge isolates did not represent distinct microbial populations.These results support tracking of population-level nasopharyngeal NTHi antibiotic resistance patterns to inform clinical management of OM in this population.

关键词： Haemophilus influenzae otitis media Antimicrobial resistance

Immunity Genes and Susceptibility to otitis media:A Comprehensive Review

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Journal of Genetics and Genomics 2014年第11期41卷 567-581页

作者： Rahul Mittal Giannina Robalino Robert Gerring Brandon Chan Denise Yan M'hamed Grati Xue-Zhong Liu Department of Otolaryngology University of Miami Miller School of Medicine Department of Human Genetics University of Miami Miller School of Medicine Department of Biochemistry University of Miami Miller School of Medicine

otitis media （OM） is a middle ear infection associated with inflammation and pain. This disease frequently afflicts humans and is the major cause of hearing loss worldwide. OM continues to be one of the most challenging diseases in the medical field due to its diverse host targets and wide range of clinical manifestations. Substantial morbidity associated with OM is further exacerbated by high frequency of recurrent infections leading to chronic suppurative otitis media （CSOM）. Children have greater susceptibility to, and thus, suffer most frequently from OM, which can cause significant deterioration in quality of life. Genetic factors have been demonstrated, in large part by twin and family studies, to be key determinants of OM susceptibility. In this review, we summarize the current knowledge on immunity genes and selected variants that have been associated with predisposition to OM. In particular, polymorphisms in innate immunity and cytokine genes have been strongly linked with the risk of developing OM. Future studies employing state-of-the-art technologies, including next-generation sequencing （NGS）, will aid in the identification of novel genes associated with susceptibility to OM. This, in turn, will open up avenues for identifying high-risk individuals and designing novel therapeutic strategies based on precise targeting of these genes.

关键词： otitis media Genetics Innate immunity Cytokines

Immunogenicity and protective immunity against otitis media caused by pneumococcus in mice of Hib conjugate vaccine with PsaA protein carrier

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Frontiers of Medicine 2016年第4期10卷 490-498页

作者： Zeyu Chen Rong Guo Jianghong Xu Chuangjun Qiu Department of Otorhinolaryngology Eye & ENT Hospital Fudan University Shanghai 200031 China Shanghai Clinical Medical Center of Hearing Medicine Shanghai 200031 China The Laboratory of Bacterial Vaccine Wuhan Institute of Biological Products Wuhan 430207 China Dingtai-Haigui Biotechnology Co. Ltd. Gu 'an 065500 China

This study evaluated the immunogenicity and protective immunity of a Hemophilus influenzae b （Hib） polysaccharide conjugate vaccine with the pneumococcal surface adhesin A （PsaA） protein carrier in young mice. The Hib polysaccharide was conjugated with the rPsaA protein carrier, which was produced using recombinant DNA technology. A total of 15 young mice aged 3 weeks to 5 weeks were immunized with the conjugate vaccine, and another 15 young mice of the same age were immunized with the licensed Hib-tetanus toxoid （TT） vaccine. Furthermore, the third group of 15 young mice was inoculated with phosphate buffer saline as control. The immunized mice were inoculated with pneumococcus in the middle ear. Results showed that IgG antibody responses against both the PsaA protein and Hib polysaccharide were observed in the Hib-PsaA group. However, no statistical difference was observed in the titer of ｜gG against the Hib polysaccharide between Hib-PsaA and Hib-TT groups. The elimination rate of pneumococcus and the inflammation of the middle ear showed the effectiveness of protective immunity against otitis media caused by pneumococcus. Our results suggest that the Hib polysaccharide can be successfully conjugated with rPsaA via amide condensation. This new Hib-PsaA conjugate vaccine can induce both anti-PsaA and anti-Hib immune responses in young mice and elicit effective protection against acute otitis media caused by pneumococcus.

关键词： conjugate vaccine pneumococcal surface adhesin A Hemophilus influenzae b immunogenicity otitis media

Granulomatosis with polyangiitis presenting as high fever with diffuse alveolar hemorrhage and otitis media: A case report

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World Journal of Clinical Cases 2021年第10期9卷 2344-2351页

作者： Xiao-Jie Li Liu Yang Xiao-Feng Yan Chu-Ting Zhan Jiang-Hua Liu Department of General Practice The Second Affiliated Hospital of Guangxi Medical UniversityNanning 530007Guangxi Zhuang Autonomous RegionChina Department of General Practice General Practice School of Guangxi Medical UniversityNanning 530007Guangxi Zhuang Autonomous RegionChina

BACKGROUND Granulomatosis with polyangiitis is a necrotizing inflammation of small andmedium-sized vessels accompanied by formation of granuloma, involvement ofprimary granulomatous upper and lower respiratory tracts, glomerulonephritis,and vasculitis of small vessels.CASE SUMMARY Herein, we described a case of a 52-year-old man admitted with pulmonarynodules and high fever. Autoantibody workup revealed that the patient waspositive for c-anti-neutrophil cytoplasmic antibodies and proteinase-3 antineutrophilcytoplasmic antibodies. Pulmonary biopsies revealed a localgranulomatous structure. The patient received therapy with methylprednisoloneand intravenous immunoglobulin, and his clinical symptoms improved.CONCLUSION Intravenous immunoglobulin may act on granulomatosis with polyangiitis similarto immunosuppressants.

关键词： Granulomatosis with polyangiitis Diffuse alveolar hemorrhage otitis media Methylprednisolone Intravenous immunoglobulin Case report

Aerobic bacteria associated with chronic suppurative otitis media in Angola

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Infectious Diseases of Poverty 2018年第1期7卷 404-413页

作者： Fabian Udden Matuba Filipe Ake Reimer Maria Paul Erika Matuschek John Thegerstrom Sven Hammerschmidt Tuula Pelkonen Kristian Riesbeck Clinical Microbiology Department of Translational MedicineFaculty of MedicineLund UniversityMalmoSweden ORL-department Hospital Josina Machel Faculty of MedicineAgostinho Neto UniversityLuandaAngola Nashalsan Höllviken AB HollvikenSweden EUCAST Development Laboratory c/o Clinical MicrobiologyCentral HospitalVaxjoSweden Department of Molecular Genetics and Infection Biology University of GreifswaldGreifswaldGermany Children’s Hospital Helsinki University HospitalHelsinkiFinland and University of HelsinkiHelsinkiFinland

Background:Chronic suppurative otitis media(CSOM)is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions.Topical antibiotics combined with aural toilet is the first-hand treatment for CSOM but antimicrobial resistance and limited availability to antibiotics are obstacles in some areas.The goal of this study was to define aerobic pathogens associated with CSOM in Angola with the overall aim to provide a background for local treatment recommendations.Methods:Samples from ear discharge and the nasopharynx were collected and cultured from 152 patients with ear discharge and perforation of the tympanic membrane.Identification of bacterial species was performed with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and pneumococci were serotyped using multiplex polymerase chain reactions.Antimicrobial susceptibility testing was done according to EUCAST.Results:One hundred eighty-four samples from ear discharge and 151 nasopharyngeal swabs were collected and yielded 534 and 289 individual isolates,respectively.In all patients,correspondence rate of isolates from 2 ears in patients with bilateral disease was 27.3%and 9.3%comparing isolates from the nasopharynx and ear discharge,respectively.Proteus spp.(14.7%),Pseudomonas aeruginosa(13.2%)and Enterococcus spp.(8.8%)were dominating pathogens isolated from ear discharge.A large part of the remaining species belonged to Enterobacteriaceae(23.5%).Pneumococci and Staphylococcus aureus were detected in approximately 10%of nasopharyngeal samples.Resistance rates to quinolones exceeded 10%among Enterobacteriaceae and was 30.8%in S.aureus,whereas 6.3%of P.aeruginosa were resistant.Conclusions:The infection of the middle ear in CSOM is highly polymicrobial,and isolates found in nasopharynx do not correspond well with those found in ear discharge.Pathogens associated with CSOM in Angola are dominated by gram-negatives including Enterobacteriaceae an

关键词： Chronic suppurative otitis media Enterobacteria Infection otitis media Proteus Pseudomonas aeruginosa

Tuberculous otitis media eseries of 10 cases

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Journal of Otology 2020年第3期15卷 95-98页

作者： Susan KSebastian Aditya Singhal Ankur Sharma Pankajkumar Doloi Department of ENT and Head&Neck Surgery St Stephen’s HospitalDelhiIndia

Background:Tuberculosis(TB)of the middle ear cleft(MEC)is a rare extra-pulmonary manifestation.Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making early diagnosis difficult.Objectives:To study the clinical presentations,complications and effective diagnostic modalities in tuberculosis of middle ear cleft.Methods:We retrospectively studied 10 patients diagnosed with chronic otitis media,unresponsive to 2 months conventional treatment.Pure tone audiogram,High resolution computed tomography(HRCT)of temporal bone,and AFB staining of ear discharge were done.All patients underwent mastoid surgery.AFB staining and histopathological examination of granulation tissue removed from the middle ear and mastoid were also done.Results:Clinical findings were mastoid swelling,facial palsy and post-aural fistula 3,4&2 patients respectively.All patients had persistent ear discharge and three had vertigo.Hearing loss was of moderate conductive type in five,sensorineural type in three and mixed type in two.HRCT of temporal bone revealed soft tissue density in MEC in 9 and evidence of bone destruction in 6 cases.Diagnosis of TB was confirmed either by(a)demonstration of AFB in ear discharge(4 patients)/tissue removed during surgery(4 patients)or(b)by demonstration of tuberculous granulomas with necrosis on histopathological examination of tissue from MEC(8 patients).Conclusion:Tuberculosis should be suspected in all cases of chronic otitis media unresponsive to conventional treatment particularly in endemic areas.Histopathological examination and AFB staining of tissue removed during mastoid surgery are reliable diagnostic methods.

关键词： Tuberculosis otitis media Mastoiditis Histopathological diagnosis

A study of knowledge,attitude and practices about otitis media in parents in Navi-Mumbai

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Journal of Otology 2021年第2期16卷 89-94页

作者： Yogesh G.Dabholkar Anmol Wadhwa Atul Deshmukh Department of ENT School of MedicineD.Y.Patil UniversityNavi MumbaiIndia Centre for Interdisciplinary Research D.Y.Patil UniversityNavi MumbaiIndia

Although otitis media poses a serious health risk in developing countries,being a frequent occurrence in children below five years of age,parental awareness and practices about otitis media have not been adequately researched.Present cross-sectional study was undertaken in Navi Mumbai schools,from October 2019 to December 2019,wherein parents with childrenotitis media in their wards.Chi-square tests,Cramer’s V were used to study association between gender,age-group and education of parents with their knowledge,practice and attitude about otitis media.Out of 425 valid responses,overall most parents displayed adequate knowledge(77%),positive attitude(61%)and good care-seeking practices(70%).There was a positive correlation of knowledge and practice with level of education.This study shows acceptable levels of knowledge,attitude and practices in parents about otitis media.Parents who did not seek treatment from health centre attributed the behaviour to poverty,ignorance and lack of health insurance.The positive correlation of knowledge and practices with level of education highlights the importance of role of education in modifying parental awareness and care seeking behaviour.Our findings call for a need to further strengthen community-based healthcare and improve parental confidence in healthcare services for early detection and adequate treatment of otitis media.

关键词： otitis media Middle ear infections Children Knowledge Attitude Practices

Helicobacter pylori in middle ear of children with otitis media with effusion

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中华医学杂志(英文版) 2011年第24期124卷 4275-4278页

作者： PARK Chul-won CHUNG Jae-ho MIN Hyun-jung KIM Kyung-rae TAE Kyung CHO Seok-hyun LEE Seung-hwan Department of Otolaryngology-Head and Neck Surgery School of MedicineHanyang UniversitySeoulKorea

Background otitis media with effusion(OME) is a common pediatric disease,but its pathogenesis remains uncertain. The relationship between OME and Helicobacter pylori(HP) is currently being studied,and a relationship has not yet been confirmed.The purpose of this study was to show that a relationship does exist between HP and OME. Methods The study consisted of 60 patients who were diagnosed with OME and had ventilation tube insertions with or without an adenoidectomy.This study included an additional 30 patients who had only received an adenoidectomy without being diagnosed with OME.The effusion samples were analyzed with polymerase chain reaction(PCR) and the campylobacter-like organism(CLO) test.The adenoid tissue samples were analyzed with the CLO test. Results Eighteen patients among the 60 patients(30%) tested positive for HP.In the cases with adenoids,15.6%of the OME patients and 13.3%of the adenoidectomy only patients were positive for HP.There were no differences between the prevalence of HP in the adenoids of OME patients and the patients without OME. Conclusion HP can be considered one of the causes of OME.

关键词： Helicobacter pylori otitis media effusion

Antibiotic Susceptibility Patterns of Isolated Bacteria from otitis media in Children at Mohamed Aden Sheikh Children Teaching Hospital in Hargeisa, Somaliland

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Journal of Biosciences and Medicines 2023年第6期11卷 57-70页

作者： Saed N. Ahmed Departments of Health Services and Public Health Ministry of Health Development Hargeisa Somaliland

Background: otitis media (OM) is a group of inflammatory diseases of the middle ear. OM is a prevailing problem among children in Hargeisa. The antibiotic susceptibility of etiologic bacteria is not investigated in Somaliland which hinders the effective treatment of OM cases in children. Objective: This study aimed at determining the etiologic bacteria and its antibiotic susceptibilities in children presenting with OM to a pediatric referral hospital in Hargeisa for the period March 2013-May 2017. Methods: A cross-sectional retrospective study was conducted on a random sample of 270 children with OM. The laboratory used standard microbiological techniques for bacterial isolation and Kirby Bauer disk diffusion method for antibiotic susceptibility testing. Data were entered and analyzed using Epi Info 7 and any associations among the study variables tested with Chi2 test with confidence level of 95% and p value of Results: The rate of bacterial isolation was 96.3%. The predominant bacterial isolate was S. aureus (31.48%) followed by P. aeruginosa (24.81%) and P. mirabilis (15.93%) respectively while the least prevalent isolates were coagulase negative Staphylococcus (1.48%), S. pyogenes (0.74%) and Enterobacter spp. (0.37%) in descending order. Age group 0 - 3, χ2 (143,270 = 223.245, p = 0.000) showed highest bacterial isolation. There was no significant relationship between bacterial isolate and gender, χ2 (11,270 = 9.2283, p = 0.6008). S. aureus showed highest sensitivity towards ciprofloxacin (85.7%), amikacin (76.5%), and gentamicin (73.8%). All isolates showed mixed resistance pattern. Conclusion: S. aureus, P. aeruginosa and P. mirabilis were the leading causative pathogens of otitis media. No association was established between isolate distribution and gender. Both the isolated gram-positive and gram-negative bacteria showed greatest sensitivity towards ciprofloxacin while the highest resistance was observed to penicillins, tetracyclines and sulfonamides. The otitis media among children

关键词： otitis media Children Etiologic Bacteria Antibiotic Susceptibility Treatment