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Alshehri S, Alahmari KA. Pediatric Acute Mastoiditis in Saudi Arabia: Demographic Insights, Clinical Profiles, and Prognostic Factors. CHILDREN (BASEL, SWITZERLAND) 2024; 11:402. [PMID: 38671619 PMCID: PMC11048861 DOI: 10.3390/children11040402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
Acute mastoiditis, a complication of otitis media, poses significant challenges in diagnosis and treatment, particularly in pediatric populations. This study aims to comprehensively evaluate the demographic characteristics, clinical features, and prognostic factors associated with acute mastoiditis in pediatric patients in Saudi Arabia. Analysis of a multicenter dataset was conducted to assess demographic variables, symptomatology, disease course, and predictors of acute mastoiditis in pediatric patients. Significant associations were found between demographic variables (age group, gender, nationality) and acute mastoiditis risk. Symptomatology analysis revealed consistent frequencies of otalgia across age groups and genders. Disease course analysis highlighted a mean duration from symptom onset to diagnosis of 14.11 days, with frequent complications like mastoid abscess and meningitis. Predictor identification identified symptoms (otalgia, fever, otorrhea), duration of illness, and complications as significant predictors of disease severity. These findings contribute valuable insights into the epidemiology and clinical management of acute mastoiditis, informing targeted interventions to improve patient outcomes.
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Affiliation(s)
- Sarah Alshehri
- Otology and Neurotology, Department of Surgery, College of Medicine, King Khalid University, Abha 61423, Saudi Arabia
| | - Khalid A. Alahmari
- Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61423, Saudi Arabia;
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Dayie NT, Bannah V, Dwomoh FP, Kotey FC, Donkor ES. Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana. Microbiol Insights 2022; 15:11786361221104446. [PMID: 35734305 PMCID: PMC9208041 DOI: 10.1177/11786361221104446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Otitis media (OM), also known as middle ear infection, is a clinically significant childhood disease. In sub-Saharan Africa, there is a paucity of contemporary reports on it is bacterial aetiologies and antimicrobial resistance among them. Aim: To investigate the OM bacterial aetiologies and their antimicrobial resistance patterns among children visiting the Ear, Nose, and Throat clinics of 3 healthcare facilities in Accra, Ghana – Princess Marie Louise Children’s Hospital, 37 Military Hospital, and Mamprobi Hospital. Methods: This cross-sectional study involved 100 children below 13 years old with suppurative otitis media. Following standard bacteriological methods, sterile ear swabs were used to take middle ear discharges from the study participants for culture and antimicrobial susceptibility testing. A standard questionnaire was also used to collect data on socio-demographic and clinical characteristics. Results: The major OM bacterial aetiologies were Pseudomonas aeruginosa (38.5%), Klebsiella pneumoniae (19.8%), Proteus mirabilis (11.5%), and Staphylococcus aureus (10.4%). The majority of the bacteria demonstrated low to moderate resistance (0%-33.3%) to most of the antibiotics. Eight of the bacteria (4 each of Klebsiella pneumoniae and Escherichia coli) were extended-spectrum beta-lactamase (ESBL) producers; 6 ampicillinase (Amp C)-producing organisms (4 Citrobacter spp. and one each of Morganella morganii and Serratia marcescens) were also identified, and they showed high antibiotic resistance. Conclusions: The predominant OM aetiologies were Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus, and they were generally susceptible to most of the antibiotics tested. Amikacin, cefepime, ciprofloxacin, and meropenem could be valuable in the empirical management of childhood OM.
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Affiliation(s)
- Nicholas Tkd Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Vida Bannah
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Felicia P Dwomoh
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,Department of Medical Laboratory, University of Ghana Medical Centre, Legon, Accra, Ghana
| | - Fleischer Cn Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
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Uddén F, Filipe M, Slotved HC, Yamba-Yamba L, Fuursted K, Pintar Kuatoko P, Larsson M, Bjurgert J, Månsson V, Pelkonen T, Reimer Å, Riesbeck K. Pneumococcal carriage among children aged 4 - 12 years in Angola 4 years after the introduction of a pneumococcal conjugate vaccine. Vaccine 2020; 38:7928-7937. [PMID: 33143954 DOI: 10.1016/j.vaccine.2020.10.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 10/23/2022]
Abstract
Children in Angola are affected by a high burden of disease caused by pneumococcal infections. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the childhood immunization programme in 2013 but the serotype distribution of Streptococcus pneumoniae and antimicrobial susceptibility patterns are unknown. We did a cross-sectional nasopharyngeal carriage study in Luanda and Saurimo, Angola (PCV13 3rd dose coverage 67% and 84%, respectively) during November to December 2017 comprising 940 children aged 4-12 years. The main objective was to assess vaccine serotype coverage and antimicrobial susceptibility rates for S. pneumoniae. Our secondary aim was to characterize colonizinig strains of Haemophilus influenzae and Moraxella catarrhalis. Pneumococcal colonization was found in 35% (95% CI 32-39%) of children (n = 332), with 41% of serotypes covered by PCV13. The most common serotypes were 3 (8%), 18C (6%), 23F (6%), 11A (6%), 34 (6%), 19F (5%) and 16 (5%). Carriage of H. influenzae and M. catarrhalis was detected in 13% (95% CI 11-15%) and 15% (95% CI 13-17%) of children, respectively. Non-susceptibility to penicillin was common among pneumococci (40%), particularly among PCV13-included serotypes (50% vs. 33%; p = 0.003), although the median minimal inhibitory concentration was low (0.19 µg/mL, IQR 0.13-0.25 µg/mL). Most pneumococci and H. influenzae were susceptible to amoxicillin (99% and 88%, respectively). Furthermore, resistance to trimethoprim-sulfamethoxazole was>70% among all three species. Multidrug-resistant pneumococci (non-susceptible to ≥ 3 antibiotics; 7% [n = 24]) were further studied with whole genome sequencing to investigate clonality as an underlying cause for this phenotype. No clearly dominating clone(s) were, however, detected. The results indicate that continued use of PCV13 may have positive direct and herd effects on pneumococcal infections in Angola as carriage of vaccine serotypes was common in the non-vaccinated age group. Finally, amoxicillin is assessed to be a feasible empirical treatment of respiratory tract infections in Angola.
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Affiliation(s)
- Fabian Uddén
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| | - Matuba Filipe
- ORL-department, Hospital Josina Machel, Luanda, Angola; Faculty of Medicine, Agostinho Neto University, Luanda, Angola
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
| | - Linda Yamba-Yamba
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| | - Kurt Fuursted
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
| | - Palmira Pintar Kuatoko
- ORL-department, Hospital Josina Machel, Luanda, Angola; Faculty of Medicine, Agostinho Neto University, Luanda, Angola
| | - Måns Larsson
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden
| | - Jonas Bjurgert
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden
| | - Viktor Månsson
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
| | - Tuula Pelkonen
- Children's Hospital, Helsinki University Hospital, Helsinki, Finland; University of Helsinki, Helsinki, Finland
| | - Åke Reimer
- ENT-Outpatient Department, Slottsstadens Läkarhus, Malmö, Sweden
| | - Kristian Riesbeck
- Clinical microbiology, Department of Translational Medicine, Faculty of Medicine, Lund university, Jan Waldenströms gata 59, SE-205 02 Malmö, Sweden.
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