Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study

Background: Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) are considered major causes of bacterial acute otitis media (AOM) worldwide, but data from Asia on primary causes of AOM are limited. This tympanocentesis-based, multi-center, cross-sectional study assess...

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Main Authors: Pavinee Intakorn, Nuntigar Sonsuwan, Suwiwan Noknu, Greetha Moungthong, Jean Yves Pirçon, Yanfang Liu, Melissa K. Van Dyke, William P. Hausdorff
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/53729
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-537292018-09-04T09:56:41Z Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study Pavinee Intakorn Nuntigar Sonsuwan Suwiwan Noknu Greetha Moungthong Jean Yves Pirçon Yanfang Liu Melissa K. Van Dyke William P. Hausdorff Medicine Background: Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) are considered major causes of bacterial acute otitis media (AOM) worldwide, but data from Asia on primary causes of AOM are limited. This tympanocentesis-based, multi-center, cross-sectional study assessed bacterial etiology and antimicrobial susceptibility of AOM in Thailand.Methods: Children 3 to 59 months presenting with AOM (< 72 hours of onset) who had not received prescribed antibiotics, or subjects who received prescribed antibiotics but remained symptomatic after 48-72 hours (treatment failures), were eligible. Study visits were conducted from April 2008 to August 2009. Bacteria were identified from middle ear fluid collected by tympanocentesis or spontaneous otorrhea swab sampling (< 20% of cases). S. pneumoniae and H. influenzae serotypes were determined and antimicrobial resistance was also assessed.Results: Of the 123 enrolled children, 112 were included in analysis and 48% of the 118 samples were positive for S. pneumoniae (23% (27/118)), H. influenzae (18% (21/118)), Moraxella catarrhalis (6% (7/118)) or Streptococcus pyogenes (3% (4/118)). The most common pneumococcal serotypes were 19F (26%) and 14 (22%). The majority of H. influenzae isolates were encapsulated (18/21), with 13 type b (Hib) representing 62% of all H. influenzae isolate or 11% of all samples (13/118), and there were only 3 non-typeable isolates. Despite high antibiotic resistance, amoxicillin/clavulanate susceptibility was high. No pneumococcal vaccine use was reported.Conclusions: S. pneumoniae and H. influenzae, both frequently antibiotic resistant, were leading causes of bacterial AOM and there was an unexpectedly high burden of Hib in this population unvaccinated by any Hib conjugate vaccine. Conjugate vaccines effective against pneumococcus and H. influenzae could potentially reduce the burden of AOM in this population. © 2014 Intakorn et al.; licensee BioMed Central Ltd. 2018-09-04T09:56:41Z 2018-09-04T09:56:41Z 2014-06-20 Journal 14712431 2-s2.0-84902761557 10.1186/1471-2431-14-157 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84902761557&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/53729
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Pavinee Intakorn
Nuntigar Sonsuwan
Suwiwan Noknu
Greetha Moungthong
Jean Yves Pirçon
Yanfang Liu
Melissa K. Van Dyke
William P. Hausdorff
Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study
description Background: Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) are considered major causes of bacterial acute otitis media (AOM) worldwide, but data from Asia on primary causes of AOM are limited. This tympanocentesis-based, multi-center, cross-sectional study assessed bacterial etiology and antimicrobial susceptibility of AOM in Thailand.Methods: Children 3 to 59 months presenting with AOM (< 72 hours of onset) who had not received prescribed antibiotics, or subjects who received prescribed antibiotics but remained symptomatic after 48-72 hours (treatment failures), were eligible. Study visits were conducted from April 2008 to August 2009. Bacteria were identified from middle ear fluid collected by tympanocentesis or spontaneous otorrhea swab sampling (< 20% of cases). S. pneumoniae and H. influenzae serotypes were determined and antimicrobial resistance was also assessed.Results: Of the 123 enrolled children, 112 were included in analysis and 48% of the 118 samples were positive for S. pneumoniae (23% (27/118)), H. influenzae (18% (21/118)), Moraxella catarrhalis (6% (7/118)) or Streptococcus pyogenes (3% (4/118)). The most common pneumococcal serotypes were 19F (26%) and 14 (22%). The majority of H. influenzae isolates were encapsulated (18/21), with 13 type b (Hib) representing 62% of all H. influenzae isolate or 11% of all samples (13/118), and there were only 3 non-typeable isolates. Despite high antibiotic resistance, amoxicillin/clavulanate susceptibility was high. No pneumococcal vaccine use was reported.Conclusions: S. pneumoniae and H. influenzae, both frequently antibiotic resistant, were leading causes of bacterial AOM and there was an unexpectedly high burden of Hib in this population unvaccinated by any Hib conjugate vaccine. Conjugate vaccines effective against pneumococcus and H. influenzae could potentially reduce the burden of AOM in this population. © 2014 Intakorn et al.; licensee BioMed Central Ltd.
format Journal
author Pavinee Intakorn
Nuntigar Sonsuwan
Suwiwan Noknu
Greetha Moungthong
Jean Yves Pirçon
Yanfang Liu
Melissa K. Van Dyke
William P. Hausdorff
author_facet Pavinee Intakorn
Nuntigar Sonsuwan
Suwiwan Noknu
Greetha Moungthong
Jean Yves Pirçon
Yanfang Liu
Melissa K. Van Dyke
William P. Hausdorff
author_sort Pavinee Intakorn
title Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study
title_short Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study
title_full Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study
title_fullStr Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study
title_full_unstemmed Haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in Thailand: A tympanocentesis-based, multi-center, cross-sectional study
title_sort haemophilus influenzae type b as an important cause of culture-positive acute otitis media in young children in thailand: a tympanocentesis-based, multi-center, cross-sectional study
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84902761557&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/53729
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