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Paker M, Pichkhadze E, Miron D, et al. Two decades of otitis media in northern Israel: Changing trends in the offending bacteria and antibiotic susceptibility. Int J Pediatr Otorhinolaryngol. 2021;152:110940doi: 10.1016/j.ijporl.2021.110940.
Paker, M., Pichkhadze, E., Miron, D., Shlizerman, L., Mazzawi, S., & Shupak, A. (2022). Two decades of otitis media in northern Israel: Changing trends in the offending bacteria and antibiotic susceptibility. International journal of pediatric otorhinolaryngology, 152110940. https://doi.org/10.1016/j.ijporl.2021.110940
Paker, Miki, et al. "Two decades of otitis media in northern Israel: Changing trends in the offending bacteria and antibiotic susceptibility." International journal of pediatric otorhinolaryngology vol. 152 (2022): 110940. doi: https://doi.org/10.1016/j.ijporl.2021.110940
Paker M, Pichkhadze E, Miron D, Shlizerman L, Mazzawi S, Shupak A. Two decades of otitis media in northern Israel: Changing trends in the offending bacteria and antibiotic susceptibility. Int J Pediatr Otorhinolaryngol. 2022 Jan;152:110940. doi: 10.1016/j.ijporl.2021.110940. Epub 2021 Nov 18. PMID: 34810003.
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Int J Pediatr Otorhinolaryngol. 2022 Jan;152:110940. doi: 10.1016/j.ijporl.2021.110940. Epub 2021 Nov 18.

Two decades of otitis media in northern Israel: Changing trends in the offending bacteria and antibiotic susceptibility.

International journal of pediatric otorhinolaryngology

Miki Paker, Elena Pichkhadze, Dan Miron, Lev Shlizerman, Salim Mazzawi, Avi Shupak

Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel. Electronic address: [email protected].
  2. Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel. Electronic address: [email protected].
  3. The Pediatric Infectious Disease Service. Emek Medical Center, Afula, Israel. Electronic address: [email protected].
  4. Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel. Electronic address: [email protected].
  5. Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel. Electronic address: [email protected].
  6. Unit of Otoneurology, Lin and Carmel Medical Centers, Haifa, Israel; Department of Communication Science and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; The Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. Electronic address: [email protected].

PMID: 34810003 DOI: 10.1016/j.ijporl.2021.110940

Abstract

OBJECTIVE: Bacteriology and antibiotic resistance trends changed considerably following introduction of the pneumococcal conjugate vaccines (PCV) 7 and 13, with differences between geographic regions. The objective of this study was to evaluate changes in acute otitis media (AOM) bacteriology and antibiotic susceptibility from the pre-vaccination period (2002-2008) to after the introduction of PCV13 (2010-2019) in northern Israel.

METHODS: Data were collected from 3277 middle ear fluid (MEF) cultures and 4822 common AOM-generating pathogens of children aged <5 years with otitis media, taken during 2002-2019. Age of the child, bacteriology, and antibiotic resistance were compared between 2002 and 2008, the pre-vaccination period when no vaccination was available and 2010-2019 when PCV13 was introduced.

RESULTS: The mean age of the children in the pre-vaccination and the vaccination periods was 18.7 ± 13.7 and 15.7 ± 12.5 months, respectively (p < 0.001); the mean age of those with group A streptococcus (GAS) positive cultures was older, p < 0.001.The prevalence of Streptococcus pneumoniae (S. pneumoniae) decreased between those periods, from 47% to 25.8%, p < 0.001, Haemophilus influenzae (H. influenza) increased from 38.4% to 47.1%, p < 0.001, GAS increased from 12.9% to 23.8%, p < 0.001, and Moraxella catarrhalis (M. cat) increased but not statistically significant from 1.7% to 3.1%. The yearly number of positive MEF cultures decreased from 395.1 to 205.6, p < 0.001. The antibiotic sensitivity rate of almost all antibiotics increased between the two study periods.

CONCLUSION: The most common MEF bacteria in northern Israel today is H. influenzae. Comparing the pre-vaccination to the vaccination period, the incidence of S. pneumonia-positive cultures decreased while GAS and H. influenza cultures increased. The age of children with positive cultures increased, and the antibiotic sensitivity rate increased. Key This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Copyright © 2021 Elsevier B.V. All rights reserved.

Keywords: Antibiotic; Bacteriology; Haemophilus influenzae; Otitis media; Pneumococcal conjugate vaccine

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