Search Our Scientific Publications & Authors

Vaccine 2019 Jan 26;37(1):1-6. Epub 2018 Nov 26.

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address:

Background: Complex otitis media (OM) may present with intact tympanic membrane or spontaneous otorrhea. We compared dynamics of intact tympanic membrane and spontaneous otorrhea OM following 7- and 13-valent conjugated vaccines (PCV7, PCV13) implementation, since differences in dynamics may imply different underlying mechanisms.

Methods: A prospective, population-based, active surveillance. Read More

Lancet Child Adolesc Health 2018 Aug 19;2(8):561-568. Epub 2018 Jun 19.

Pfizer Vaccines Clinical Research and Development, Collegeville, PA, USA.

Background: With wide use of the seven-valent pneumococcal conjugate vaccine (PCV7) for protection against acute otitis media caused by Streptococcus pneumoniae serotypes included in the vaccine, efficacy testing for the 13-valent vaccine (PCV13) was not feasible. We aimed to assess the effectiveness of PCV13 in preventing acute otitis media caused by the six serotypes in PCV13 that were not in PCV7.

Methods: We did a longitudinal observational study in healthy children seen as outpatients in a private paediatric practice in Rochester, NY, USA. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Aug;31(15):1168-1173

Department of Otorhinolaryngology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.

To investigate the influencing factors of recurrent episodes of otitis media with effusion in children.A retrospective summary of the clinical data of 210 cases of children with otitis media with effusion, 75 cases of recurrence after treatment, 135 cases were recovered, the recurrence of the related factors and after symptomatic treatment effect is analyzed.Logistic regression analysis results found that adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°) and sinusitis (including choanal polyp), a positive allergens, upper respiratory tract infection, the stomach esophagus regurgitation, cleft palate, younger age has significant effect on recurrence of otitis media with effusion, have significant difference (< 0. Read More

Pediatr Infect Dis J 2018 Jun;37(6):598-604

From the Department of Infectious Diseases, Keio University, School of Medicine.

Background: Acute otitis media is a leading cause of childhood morbidity and antibiotic prescriptions. We examined etiologic changes in acute otitis media after introduction of 13-valent pneumococcal conjugate vaccine as routine immunization for Japanese children in 2014. Serotypes, resistance genotypes, antibiotic susceptibilities and multilocus sequence typing of pneumococcal isolates were also characterized. Read More

Pediatrics 2017 Sep 7;140(3). Epub 2017 Aug 7.

Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York

Objectives: To study the epidemiology of acute otitis media (AOM), especially the otitis-prone condition, during the pneumococcal conjugate vaccines 7 and 13 era.

Methods: Six hundred and fifteen children were prospectively managed from 6 to 36 months of life during a 10-year time frame (June 2006-June 2016). All clinical diagnoses of AOM were confirmed by tympanocentesis and bacterial culture of middle ear fluid. Read More

Medicine (Baltimore) 2017 Feb;96(6):e5974

aUnidad de Otorrinolaringología, Hospital Sótero del Rio, Puente Alto, Santiago, Chile bMerck & Co, Sao Paulo, Brazil; at the time of the study Takeda Pharmaceuticals, Sao Paulo, Brazil cGSK Pharmaceuticals Ltd, Bangalore, India dGSK Buenos Aires, Argentina eGSK Panama, Panamá.

The impact of bacterial conjugate vaccines on acute otitis media (AOM) is affected by several factors including population characteristics, bacterial etiology and vaccine conjugation method, carrier, and coverage. This study estimated the baseline etiology, distribution, and antibiotic susceptibility of bacterial serotypes that causes AOM in children aged <5 years in a public setting in Santiago, Chile.Children aged ≥3 months and <5 years referred to the physician for treatment of AOM episodes (with an onset of symptoms <72 h) were enrolled between September 2009 and September 2010. Read More

Ear Nose Throat J 2017 Jan;96(1):20-28

Department of Otorhinolaryngology-Head and Neck Surgery, Soroka University Medical Center and Faculty of Health Sciences, Beer Sheva, Israel.

We conducted a retrospective chart review to characterize the outcomes of 12 patients-9 men and 3 women, aged 21 to 79 years (mean: 49)-who had been treated at our tertiary care center for acute bacterial meningitis caused by acute otitis media (ABMAO). Fever was the most common presenting sign/symptom, observed in 8 patients, followed by otalgia, neck stiffness, headache, and confusion. An opaque and bulging tympanic membrane was observed in 8 patients. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Jan;31(2):157-158

A young female complained left ear fullness for over three months. She has a history of tympanocentesis one year before. Nasal endoscopic inspection reported that left nose pharynx ministry is derived from the vegetations of eustachian tube. Read More

Int J Pediatr Otorhinolaryngol 2017 Jan 10;92:32-37. Epub 2016 Nov 10.

Department of Pediatrics, Hospital Prof. Doutor Fernando Fonseca, EPE, Estrada IC-19, 2720-276, Amadora, Portugal. Electronic address:

Background: Acute mastoiditis (AM) is a suppurative infection of the mastoid air cells, representing the most frequent complication of acute otitis media. AM remains an important entity in children due to its potential complications and sequelae. We aim to describe the cases of AM admitted at our department, identify risk factors potentially associated with complications and analyse the changes in clinical approach of AM over time. Read More

Pediatr Infect Dis J 2017 03;36(3):274-281

From the *GSK Vaccines, Wavre, Belgium; †Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Saint-Maur-des-Fossés, CHI Créteil and UPEC, France; ‡Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, and §Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; ¶Unidad de Otorrinolaringologia, Hospital Dr Sotero del Rio, Puente Alto, Santiago, Chile; ‖Departamento de Infectologia, Instituto Nacional de Pediatría de la Secretaría de Salud (SSA), Mexico City, Mexico; **Otolaryngology Department, King Saud University & King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; ††ENT-Center, Prinzenweg 1, 82319 Starnberg, Germany; ‡‡Centros de Estudios Infectologia Pediatrica, Cali, Colombia; §§GSK Biologicals, Ciudad Panama, Panama; ¶¶Sección de ORL Pediátrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; and ‖‖Otolaryngology Department, Faculty of Medicine Chiang Mai University, Chiang Mai, Thailand.

Background: Acute otitis media (AOM) is an important cause of childhood morbidity and antibiotic prescriptions. However, the relative importance of the well-known otopathogens, Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hflu), remains unclear because of a limited number of tympanocentesis-based studies that vary significantly in populations sampled, case definitions and heptavalent pneumococcal conjugate vaccine use.

Methods: We conducted a pooled analysis of results from 10 AOM etiology studies of similar design, the protocols of which were derived from a common protocol and conducted in children 3 months to 5 years of age in different countries. Read More

Am J Epidemiol 2016 Nov 15;184(9):652-659. Epub 2016 Oct 15.

Pneumococcal conjugate vaccines (PCVs) have substantially reduced the burden of pneumococcal disease, including the incidence of otitis media (OM). However, in most countries, no surveillance exists to monitor the change in pneumococcal OM incidence after the introduction of PCVs. We explored whether measuring pneumococcal carriage was a useful surrogate for monitoring postvaccination changes in the incidence of pneumococcal OM. Read More

An Pediatr (Barc) 2016 Nov 9;85(5):224-231. Epub 2016 Mar 9.

GSK Pharmaceuticals Pvt. Ltd., Bangalore, India.

Introduction: Acute otitis media (AOM) is common in children aged <3 years. A pneumococcal conjugate vaccine (PCV) (PCV7; Prevenar, Pfizer/Wyeth, USA) has been available in Spain since 2001, which has a coverage rate of 50-60% in children aged <5 years.

Materials And Methods: Children aged ≥3 to 36 months with AOM confirmed by an ear-nose-throat specialist were enrolled at seven centers in Spain (February 2009-May 2012) (GSK study identifier: 111425). Read More

Pediatr Infect Dis J 2016 09;35(9):1033-9

From the Center for Infectious Disease and Immunobiology, Rochester General Hospital Research Institute, Rochester, New York.

This review summarizes a prospective, longitudinal 10-year study in Rochester, NY, with virtually every clinically diagnosed acute otitis media (AOM) confirmed by bacterial culture of middle ear fluid. Children experiencing 3 episodes within 6 months or 4 episodes in 12 months were considered stringently defined otitis prone (sOP). We found stringent diagnosis compared with clinical diagnosis reduced the frequency of children meeting the OP definition from 27% to 6% resulting in 14. Read More

Int J Pediatr Otorhinolaryngol 2016 Apr 12;83:200-4. Epub 2016 Feb 12.

University of Rochester, Rochester, NY, United States.

Objective: We sought to develop an optimal model using a combination of serum biomarker pro-inflammatory and dampening inflammatory cytokine proteins to predict the presence of acute otitis media (AOM) infection and recovery caused by Nontypeable Haemophilus influenzae (NTHi).

Methods: 88 serum samples were studied from 34 children 6-36 months of age at healthy visits, at onset of AOM diagnosed by qualified pediatricians and confirmed by tympanocentesis to be caused by NTHi and follow up 3 weeks to 4 months later. Immunoassays were used to quantitate serum S100A12, IL-10 and sICAM-1 cytokine levels. Read More

BMC Infect Dis 2016 Mar 9;16:118. Epub 2016 Mar 9.

GlaxoSmithKline Vaccines, Wavre, Belgium.

Pediatr Infect Dis J 2015 Feb;34(2):195-9

From the *Department of Otolaryngology-Head and Neck Surgery, †Pediatric Allergy/Immunology Unit, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel; ‡Public Health Services, Israel Ministry of Health, Jerusalem, Israel; and §Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Background: The widespread use of 7-valent pneumococcal conjugate vaccine (PCV7) has changed acute otitis media (AOM) bacteriology. Only scattered data with regard to this effect of PCV13 have been published so far.

Methods: We retrospectively identified children <6 years of age who presented to our hospital with AOM, and had middle ear fluid (MEF) cultures obtained during tympanocentesis or from spontaneous otorrhea during 2008-2013, when PCV7 (2009) and PCV13 (2010) were gradually introduced in the Israeli National Immunization Program. Read More

Clin Otolaryngol 2015 Aug;40(4):370-7

Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel.

Background: Pneumococcal acute otitis media (AOM) has been previously considered as a more severe disease than that caused by other otopathogens, based on clinical and/or otologic scores. We sought to test this hypothesis in the pneumococcal conjugated vaccine (PCV) era.

Methods: Children <6 years who presented with 'severe' AOM episodes with middle ear fluid (MEF) cultures during 2008-2013 were retrospectively identified. Read More

Medicine (Baltimore) 2015 Jan;94(2):e320

From the Instituto de Atención Pediátrica, San José, Costa Rica (AAb, AAr, CS); Universidad Autónoma de Ciencias Médicas, San José, Costa Rica (AAr); Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel (RDa, NP); GlaxoSmithKline Vaccines, Panama City, Panama (MMC, EO-B, RDA) GlaxoSmithKline Vaccines, Wavre, Belgium (RC, J-YP, RD, MVD).

Acute otitis media (AOM) microbiology was evaluated in children after 7-valent pneumococcal conjugate vaccine (PCV7) introduction in Costa Rica (private sector, 2004; National Immunization Program, 2009). This was a combined prospective and retrospective study conducted in a routine clinical setting in San José, Costa Rica. In the prospective part of the study, which was conducted post-PCV7 introduction (2010-2012), standard bacteriological procedures were used to evaluate the etiology and serotype distribution of middle ear fluid samples collected by tympanocentesis or otorrhea from children aged 3-59 months diagnosed with AOM. Read More

BMC Infect Dis 2014 Dec 5;14:640. Epub 2014 Dec 5.

Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, 14621, Rochester, NY, USA.

Background: We sought to determine if nasopharyngeal (NP) cultures taken at times of healthy visits or at onset of acute otitis media (AOM) could predict the otopathogen mix and antibiotic-susceptibility of middle ear isolates as determined by middle ear fluid (MEF) cultures obtained by tympanocentesis.

Methods: During a 7-year-prospective study of 619 children from Jun 2006-Aug 2013, NP cultures were obtained from 6-30 month olds at healthy visits and NP and MEF (by tympanocentesis) at onset of AOM episodes.

Results: 2601 NP and 530 MEF samples were collected. Read More

Laryngoscope 2015 Jan 12;125(1):E39-44. Epub 2014 Sep 12.

Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester.

Objectives/hypothesis: Acute otitis media (AOM) is a common bacterial infection in childhood that causes an inflammatory response in the middle ear. Leukocytes produce different inflammatory molecules in vitro when stimulated with Gram-positive and Gram-negative bacteria. The major causes of AOM are Streptococcus pneumoniae, nontypeable Haemophilus influenza, and Moraxella catarrhalis. Read More

J Epidemiol Glob Health 2014 Sep 21;4(3):231-8. Epub 2014 Apr 21.

GlaxoSmithKline Vaccines, Avenue Fleming 20, 1300 Wavre, Belgium. Electronic address:

Background: Information regarding acute otitis media (AOM) aetiology is important for developing effective vaccines. Here, bacterial aetiology and antimicrobial susceptibility of AOM were determined in young Saudi children.

Methods: Children aged 3-60months with a new episode of AOM, who had not received antibiotics or had received antibiotics for 48-72h but remained symptomatic, were enrolled in this prospective, observational, epidemiological study in Riyadh. Read More

BMC Pediatr 2014 Jun 20;14:157. Epub 2014 Jun 20.

Department of Otolaryngology, Queen Sirikit National Institute of Child Health, 420/8 Rajvithi Road, Rajthevee, Bangkok 10400, Thailand.

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. Read More

Clin Vaccine Immunol 2014 Aug 11;21(8):1189-91. Epub 2014 Jun 11.

Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel

Following the introduction of the 7- and 13-valent pneumococcal conjugate vaccines, we observed an inverse relationship between the increasing rate of immunized children and the proportion of middle ear fluid cultures collected during acute mastoiditis episodes that tested positive for Streptococcus pneumoniae among a subset of children 0 to 6 years old who had initially presented with severe acute otitis media and had bacterial cultures collected during tympanocentesis or from spontaneous otorrhea. Read More

J Antimicrob Chemother 2014 Sep 2;69(9):2394-9. Epub 2014 Jun 2.

Antibiotic and Haemophilus Laboratory, Bacteriology Service, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain Consejo Superior de Investigaciones Científicas, Madrid, Spain

Objectives: Non-typeable Haemophilus influenzae are a major cause of acute otitis media (AOM), including chronic and recurrent otitis in young children. The objective of this study was to determine whether non-typeable H. influenzae isolates causing these infections produce biofilms and carry resistance mechanisms to β-lactams. Read More

Cochrane Database Syst Rev 2013 Dec 13(12):CD004975. Epub 2013 Dec 13.

Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, 123 Friendship Road, Khon Kaen, Thailand, 40002.

Background: Acute otitis media (AOM) is a common problem in children, for which amoxicillin, with or without clavulanate, is frequently prescribed as a treatment of choice. The conventional recommendation is either three or four daily doses. However, nowadays it is frequently prescribed as once or twice daily doses. Read More

J Microbiol Immunol Infect 2014 Jun 27;47(3):239-44. Epub 2013 Sep 27.

Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

Background: Acute otitis media (AOM) is one of the most frequent bacterial infections in children. Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) are the two major bacterial pathogens. Pneumococcal conjugate vaccine was introduced into Taiwan in 2005 and only some children were vaccinated. Read More

Curr Allergy Asthma Rep 2013 Oct;13(5):495-500

Acute otitis media (AOM) is a common disease in young children. Streptococcus pneumoniae (Spn) and Haemophilus influenzae (NTHi) are the two most common pathogens that cause AOM. Over the past 5 years, our group has been studying the immunologic profile of children that experience repeated AOM infections despite tympanocentesis drainage of middle ear fluid and individualized antibiotic treatment; we call these children stringently-defined otitis prone(sOP). Read More

J Clin Microbiol 2013 Nov 21;51(11):3542-6. Epub 2013 Aug 21.

Department of Infection Control and Laboratory Diagnostics, Tohoku University Graduate School of Medicine, Sendai, Japan.

Acute otitis media (AOM) is the most common upper respiratory tract infection in childhood. Children with AOM were enrolled at Tohoku Rosai Hospital between July 2006 and June 2011 if their middle ear fluid cultures after tympanocentesis yielded only Haemophilus influenzae. The susceptibilities of the isolates to ampicillin were determined, and microtiter biofilm assays and invasion assays using BEAS-2B cells were performed. Read More

Pediatr Infect Dis J 2013 Aug;32(8):805-809

Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, Rochester, NY 14621.

Background: The otopathogen distribution colonizing the nasopharynx (NP) and causing acute otitis media (AOM) is in flux following the introduction of pneumococcal conjugate vaccine 7 (PCV7) and will continue to change.

Methods: Two hundred seventy-seven children were followed prospectively; tympanocentesis was performed during AOM and 208 NP samples were collected to compare with middle ear fluid (MEF) isolates. Eight hundred sixty-three NP samples were collected at 7 healthy visits between 6 and 30 months of age. Read More

J Infect Dis 2013 Oct 10;208(7):1152-60. Epub 2013 Jul 10.

Pediatric Infectious Diseases Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Background: Complex (ie, recurrent, nonresponsive, or chronic) otitis media (OM) is frequent and is often caused by a mixed-pathogen infection with biofilm formation. We conducted this study to characterize children with OM due to mixed Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) infections (M-OM) and those with OM due to single, S. pneumoniae-only infections (S-OM) and to examine whether pneumococcal serotypes associated with M-OM differed from those associated with S-OM. Read More

Laryngoscope 2013 Sep 8;123(9):2148-53. Epub 2013 Jul 8.

Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Objectives/hypothesis: Postirradiation otitis media with effusion (OME) is a common adverse otologic effect in nasopharyngeal carcinoma (NPC) patients treated by radiotherapy. The purpose of this study was to determine the long-term incidence of postirradiation OME in NPC patients following intensity-modulated radiotherapy (IMRT) and to evaluate the potential factors associated with the development of this otologic complication.

Study Design: Retrospective observational study. Read More

Int J Pediatr Otorhinolaryngol 2013 Aug 6;77(8):1231-6. Epub 2013 Jun 6.

Hospital Infantil Universitario Vall d'Hebrón, Barcelona, Spain.

Objective: To prospectively identify the bacterial aetiology and antimicrobial susceptibility of problematic (recurrent and treatment failure) acute otitis media in Spanish children several years after the introduction of 7-valent pneumococcal conjugate vaccine.

Methods: Tympanocentesis or careful sampling of spontaneous otorrhoea was performed on children aged 3 to <36 months with recurrent acute otitis media, acute otitis media treatment failure or unresolved acute otitis media.

Results: 105 acute otitis media episodes (77 sampled by tympanocentesis, 28 otorrhoea samples) were evaluated: 46 recurrent, 35 treatment failures, 24 unresolved acute otitis media. Read More

Pediatr Infect Dis J 2013 Nov;32(11):1159-62

From the *Rochester General Hospital Research Institute; and †Legacy Pediatrics, Rochester, NY.

Objective: We sought to determine whether recurrent acute otitis media (rAOM) occurring within 30 days of amoxicillin/clavulanate treatment was caused by bacterial relapse or new pathogens.

Methods: Pneumococcal conjugate vaccinated children, age 6-36 months, enrolled in a prospective, longitudinal study experiencing rAOM<1 month after completing amoxicillin/clavulanate therapy were studied. AOM episodes occurred between June 2006 and November 2012. Read More

Int J Pediatr Otorhinolaryngol 2013 Jun 17;77(6):976-80. Epub 2013 Apr 17.

Otolaryngology Department, Hospital de Pediatría SAMIC Prof. Dr. Juan P. Garrahan, Combate de Pozos 1881 CABA, Argentina.

Unlabelled: The true incidence of acute otitis media (AOM) in neonates and infants younger than three months is unknown. In this population organisms causing AOM may disseminate leading to bacteremia, sepsis, and meningitis [1].

Objectives: To describe the clinical presentation, associated severe infections, bacteriologic etiology, and antibiotic resistance patterns of organisms isolated from the middle ear of infants younger than three months that were not vaccinated against Streptococcus pneumoniae. Read More

Int J Infect Dis 2013 Sep 20;17(9):e702-6. Epub 2013 Mar 20.

Department of Pediatrics, Children's Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania.

Objective: To assess the epidemiological and microbiological characteristics of pneumococcal acute otitis media (AOM) in children in Brasov, Central Romania, before the introduction of pneumococcal conjugate vaccine (PCV) into the routine national immunization program.

Methods: All AOM patients aged <5 years who underwent tympanocentesis or presented with purulent otorrhea of ≤24h duration during 2009-2011 were enrolled.

Results: Two hundred and twelve consecutive AOM patients had a middle ear fluid (MEF) culture performed; 99 (46. Read More

Pediatr Infect Dis J 2013 May;32(5):473-8

Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester NY 14621, USA.

Objective: We sought to determine if use of more stringent diagnostic criteria for acute otitis media (AOM) than currently advocated by the American Academy of Pediatrics, tympanocentesis and pathogen-specific antibiotic treatment (individualized care) would result in reducing the incidence of recurrent AOM and consequent tympanostomy tube surgery.

Methods: A 5-year longitudinal, prospective study in Rochester, NY, was conducted from July 2006 to July 2011 involving 254 individualized care children. When this individualized care group developed symptoms of AOM, strict diagnostic criteria were applied and a tympanocentesis was performed. Read More

Int J Pediatr Otorhinolaryngol 2013 Feb 2;77(2):303-5. Epub 2012 Dec 2.

Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University, Bucheon Hospital, Bucheon, Republic of Korea.

Common bacterial pathogens of otitis media include Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, alpha-hemolytic streptococci, and Group A streptococci. We recently isolated a gram-negative, rod-shaped, non-spore-forming bacterium from a patient with otitis media following tympanocentesis. 16S rRNA gene sequence similarity studies of effusion identified this strain (CCUG 43427AT) as Massilia sp. Read More

BMC Infect Dis 2012 Nov 20;12:312. Epub 2012 Nov 20.

ENT Center, Prinzenweg 1, 82319, Starnberg, Germany.

Background: Acute Otitis Media (AOM) is an important and common disease of childhood. Bacteria isolated from cases of clinically problematic AOM in German children were identified and characterized.

Methods: In a prospective non-interventional study in German children between 3 months and less than 60 months of age with Ear, Nose and Throat Specialist -confirmed AOM, middle ear fluid was obtained by tympanocentesis (when clinically indicated) or by careful sampling of otorrhea through/at an existing perforation. Read More

J Formos Med Assoc 2012 Oct 13;111(10):536-41. Epub 2012 Mar 13.

Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.

Background/purpose: Acute otitis media (AOM) is one of the most common diseases in children. Here, we describe the epidemiological and microbiological characteristics of AOM in Taiwanese children over a 10-year period.

Methods: We retrospectively enrolled pediatric patients with culture-proven AOM who were treated at Mackay Memorial Hospital, Taipei between 1999-2008. Read More

J Otolaryngol Head Neck Surg 2012 Aug;41(4):282-7

IWK Health Centre, Division of Otolaryngology, Department of Surgery, Dalhousie University, Halifax, NS.

Objective: This study was completed to evaluate the middle ear microbiology of a pediatric population with chronic otitis media with effusion and to determine if there has been a change in the spectrum of microorganisms or their antibiotic susceptibility in the modern age of antibiotic therapy.

Design: Retrospective chart review.

Setting: A Canadian academic pediatric otolaryngology practice. Read More

Acta Otorrinolaringol Esp 2013 Jan-Feb;64(1):12-6. Epub 2012 Aug 2.

Servicio de Otorrinolaringología, Hospital Nacional de Pediatría SAMIC Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.

Background And Objective: Acute otitis media (AOM) is one of the most common diseases in childhood and is the most common cause of antibiotic prescriptions in children. The gold standard for identifying the pathogens causing AOM is tympanocentesis. This is only possible in the stage of AOM when exudate is retained in the middle ear. Read More

BMC Infect Dis 2012 Feb 15;12:40. Epub 2012 Feb 15.

Policlínica Metropolitana, Piso 1, consultorio 1-13, Urbanización Caurimare, Calle A-1, Caracas, Venezuela.

Background: Non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae are major causes of bacterial acute otitis media (AOM). Data regarding AOM are limited in Latin America. This is the first active surveillance in a private setting in Venezuela to characterize the bacterial etiology of AOM in children < 5 years of age. Read More

Mikrobiyol Bul 2011 Oct;45(4):723-8

Karadeniz Technical University, Department of Medical Microbiology, Trabzon, Turkey.

Candida parapsilosis, which has recently gained increasing importance, is the second most common fungal pathogen isolated from clinical specimens. C.parapsilosis strains exhibiting genetic heterogeneity were previously considered as a complex of three genetically different groups (group I, II, III). Read More

Acta Otorrinolaringol Esp 2012 Jan-Feb;63(1):21-5. Epub 2011 Oct 5.

Servicio de Otorrinolaringología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, CABA, Argentina.

Background: To describe the clinical features of intratemporal complications of acute otitis media (AOM) in children, a retrospective study was carried out for two years.

Methods: We considered acute mastoiditis, presence of postauricular swelling, erythema and tenderness and anteroinferior displacement of the auricle; labyrinthitis, presence of vestibular symptoms (spontaneous nystagmus and ataxia with or without vomiting; and facial nerve palsy, absence or decreased motility in hemiface. All children underwent otomicroscopy for evidence of coexistent or recent AOM. Read More

Salud Publica Mex 2011 May-Jun;53(3):207-11

Hospital Infantil de México Federico Gómez, México, DF, México.

Objective: The aim of this study was to identify the etiology and the serotypes of S. pneumoniae (Sp) in Mexican children with acute otitis media (AOM).

Materials And Methods: The study includessamples frompatientsdiagnosed with AOM at the Federico Gomez Children's Hospital of Mexico (2002-2003),with positive culture for Sp bacteriologically confirmed in middle ear fluid obtained by tympanocentesis. Read More

Vaccine 2011 Jul 17;29(33):5544-9. Epub 2011 May 17.

Instituto Nacional de Pediatria, Insurgentes Sur 3700-C, Insurgentes Cuicuilco, México 04530, Mexico.

Streptococcus pneumoniae and Haemophilus influenzae have been consistently reported to be the two major bacterial pathogens responsible for acute otitis media (AOM), mainly from studies in the US and Europe. However, data on bacterial pathogens causing AOM in Latin America are limited. Understanding the relative importance of these pathogens in a specific setting, the serotype distribution, and their antibiotic susceptibility levels is important to provide local vaccine and treatment recommendations. Read More

Otol Neurotol 2011 Jul;32(5):799-804

Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.

Objective: Otitis media with effusion (OME) is the major reason for failure of neonatal hearing screening. However, little is known about the impact on hearing status of OME in infants during the first months of life.

Patients: Infants who failed universal newborn hearing screening. Read More

Clin Infect Dis 2011 May;52 Suppl 4:S277-83

Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.

Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. Read More

Hum Vaccin 2011 Jan 1;7(1):102-5. Epub 2011 Jan 1.

Rochester General Hospital, Rochester General Research Institute, Center for Infectious Diseases and Immunology, Rochester, NY, USA.

An outer membrane protein of nontypeable Haemophilus influenzae (NTHi), P6, is a vaccine candidate because it has been characterized as conserved among all H. influenzae strains. Among 151 isolates from children, age 6 to 30 months, evaluating NTHi nasopharyngeal (NP) and oropharyngeal (OP) colonization and tympanocentesis confirmed acute otitis media we identified 14 strains (9. Read More

Int J Infect Dis 2011 Apr 26;15(4):e240-8. Epub 2011 Jan 26.

Instituto de Atención Pediátrica, PO Box 607-1150, La Uruca, San José, Costa Rica.

Objectives: A randomized, double-blind, double-dummy, multicenter international study was conducted to assess the clinical and bacteriologic response, safety, and compliance of a single 60-mg/kg dose of azithromycin extended-release (ER) versus a 10-day regimen of amoxicillin/clavulanate 90/6.4 mg/kg per day in children with acute otitis media at high risk of persistent or recurrent middle ear infection.

Methods: Children aged 3 to 48 months were enrolled and stratified into two age groups (≤ 24 months and >24 months). Read More