A Multiple Drug-Resistant Streptococcus pneumoniae Caused Acute Otitis Media

Year 2020, Volume: 3 Issue: 1, 35 - 39, 30.01.2020

Fatma Koksal Cakirlar Serhat Sirekbasan , Ebru Tugrul Saribeyoglu Emine Er Mustafa Samasti

Abstract

Acute otitis media (AOM), known to be a common pediatric disease is a suppurative infection of the middle ear and air spaces. Causative agent of AOM is often Streptococcus pneumoniae in all the world's children. In the last decades there has been a striking increase in the incidence of penicillin-resistant and multiply antibiotic-resistant pneumococci. The high prevalence of multidrug resistant S. pneumoniae is a clinical problem for medical personnel in the selection of empiric antibacterial treatments. Here we notify a case of a 9-month-old boy with bilateral acute otitis media caused by multi-drug resistant S. pneumoniae. A multiple drug-resistant S. pneumoniae strain was isolated in otorrhea sample obtained from bilateral middle ear of the child with complaints of persistent otitis media. Antibiotic sensibilities were analyzed with disc diffusion and E-test method. The detection of pneumococcal serotype was determined by capsular swelling reaction and sequence type was conducted by multilocus sequence typing (MLST). The serotype was determined as 19A and the sequence type was found ST199. These case report were evaluated in order to draw attention to the increase of pneumococcal AOM infections with multi-drug resistant in among children.

Keywords

Acute otitis media, Children, Multiple drug-resistant, Streptococcus pneumoniae

Çoklu İlaç Dirençli Streptococcus pneumoniae Kaynaklı Akut Otitis Media

Abstract

Akut otitis media (AOM) orta kulak ve hava boşluklarının süpüratif enfeksiyonu olup, yaygın bir pediatrik hastalıktır. AOM'nin etkensel ajanı, tüm dünya çocuklarında sıklıkla Streptococcus pneumoniae'dir. Son birkaç on yılda, penisiline dirençli ve çoklu ilaca dirençli pnömokok insidansında çarpıcı bir artış olmuştur. Çoklu ilaca dirençli S. pneumoniae’nin yüksek prevalansı, ampirik antimikrobiyal tedavi seçiminde uygulayıcılar için klinik bir zorluktur. Bu yazıda, çoklu ilaca dirençli S. pneumoniae'nin neden olduğu iki taraflı akut otitis media’sı olan 9 aylık bir erkek olgu sunuldu. Persistan otitis media şikayeti olan çocuğun iki taraflı orta kulağından elde edilen akıntı örneğinde çoklu ilaca dirençli bir S. pneumoniae suşu izole edildi. Antibiyotik duyarlılıkları disk difüzyon ve E-test yöntemiyle analiz edildi. Pnömokokal serotip tespiti kapsüler şişme reaksiyonu ile belirlendi ve sekans tipi multilokus dizilimiyle (MLST) yapıldı. Serotip 19A olarak belirlendi ve dizi tipi ST199 olarak bulundu. Çocuklarda çoklu ilaca dirençli pnömokokal AOM infeksiyonlarının artışına dikkat çekmek amacıyla bu olgu sunumu değerlendirilmiştir.

Keywords

Çocuklar, Çoklu ilaç direnci, Streptococcus pneumonia, MLST

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