Abstract
Since 1980 we have observed an epidemic of AOM caused by Bc; 75% of strains produce beta-lactamase (BL+). To determine clinical significance of this infection, we studied pharyngeal colonization, clinical presentation and outcome of therapy.
Bc was present in MEE of 61/355 children enrolled in randomized, prospective clinical trials (17%); the proportion has not changed since 1980. Bc was present in pure culture in 40/61 (66%) and as a mixed infection with S. pneumoniae or H. influenzae in 21 (34%). AOM caused by Bc was less common in spring/ summer 112/110 (11%) than in fall/winter 49/245 (20%) (p < .05). Colonization with Bc was also less common in summer (6/56)(11%) than winter (36/71) (50%) (p < .01).
Persistent MEE was present 2 wk. after Bc infection in 83% and at 4 wk. in 63%; the proportions were not significantly different in other etiologic groups. Culture of MEE was performed routinely during therapy. Failure to sterilize Bc-infected MEE was seen with Amoxicillin/Bacampicillin - 3/11 patients; Cefaclor - 2/19; Trimethoprim-sulfamethoxazole - 0/10; Augmentin - 0/9. All failures were with BL+ stains.
AOM caused by Bc occurs when respiratory colonization rates are high. Therapy with some drugs may not give prompt sterilization of MEE. In otherwise healthy children Bc lacks invasive potential; changes in routine prescribing may not be needed even when infection with BL+ Bc is frequent.
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Shurin, P., Marchant, C., Hare, G. et al. 1163 BIOLOGY AND THERAPY OF ACUTE OTITIS MEDIA (AOM) CAUSED BY BRANHAMELLA CATARRHALIS (Bc). Pediatr Res 19, 304 (1985). https://doi.org/10.1203/00006450-198504000-01193
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DOI: https://doi.org/10.1203/00006450-198504000-01193