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- Title
Antibiotic Resistance of Haemophilus influenzae in Nasopharyngeal Carriage of Children with Acute Otitis Media and in Middle Ear Fluid from Otorrhea.
- Authors
Assad, Zein; Cohen, Robert; Varon, Emmanuelle; Levy, Corinne; Bechet, Stéphane; Corrard, François; Werner, Andreas; Ouldali, Naïm; Bonacorsi, Stéphane; Rybak, Alexis
- Abstract
Haemophilus influenzae (Hi) is one of the leading bacteria implicated in childhood acute otitis media (AOM). Recent concerns have been raised about the emergence of Hi-resistant strains. We aimed to analyze the evolution of β-lactam resistance to Hi among strains isolated from nasopharyngeal carriage in children with AOM and in mild ear fluid (MEF) after the spontaneous perforation of the tympanic membrane (SPTM) in France. In this national ambulatory-based cohort study over 16 years, we analyzed the rate of Hi nasopharyngeal carriage and the proportion of β-lactam-resistant Hi strains over time using a segmented linear regression model. Among the 13,865 children (median [IQR] age, 12.7 [9.3–17.3] months; 7400 [53.4%] male) with AOM included from November 2006 to July 2022, Hi was isolated in 7311 (52.7%) children by nasopharyngeal sampling. The proportion of β-lactamase-producing and β-lactamase-negative, ampicillin-resistant (BLNAR) Hi strains in nasopharyngeal carriage remained stable during the study period. Among the 783 children (median [IQR] age, 20 [12.3–37.8] months; 409 [52.2%] male) with SPTM included from October 2015 to July 2022, Hi was isolated in 177 (22.6%) cases by MEF sampling. The proportions of β-lactamase-producing and BLNAR Hi strains did not significantly differ between nasopharyngeal (17.6% and 8.8%, respectively) and MEF (12.6% and 7.4%) samples. Accordingly, amoxicillin remains a valid recommendation as the first-line drug for AOM in France.
- Subjects
FRANCE; ACUTE otitis media; MIDDLE ear; HAEMOPHILUS influenzae; DRUG resistance in bacteria; TYMPANIC membrane perforation; KLEBSIELLA pneumoniae; MYCOPLASMA bovis
- Publication
Antibiotics (2079-6382), 2023, Vol 12, Issue 11, p1605
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics12111605