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Nasopharyngeal cultures had low predicative value for epidemiology of AOM
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WASHINGTON, D.C. — New data presented at ICAAC 2014 indicated nasopharyngeal cultures were not suitable substitutes for middle ear fluid cultures when predicting otopathogen mix and antibiotic susceptibility among children with acute otitis media.
Ravinder Kaur, PhD, of Rochester General Hospital in Rochester, N.Y., and colleagues conducted a 7-year prospective study that compared nasopharyngeal cultures and middle ear fluid cultures from 619 children with acute otitis media (AOM). Nasopharyngeal cultures were obtained from children ages 6 to 30 months at well visits and middle ear fluid cultures (via tympanocentesis) and nasopharyngeal cultures were obtained at onset of AOM. The study included 2,601 nasopharyngeal cultures and 530 middle ear fluid cultures.
Ravinder Kaur
Streptococcus pneumoniae was isolated from 31.7% of nasopharyngeal cultures obtained during the well visits. Non-typeable Haemophilus influenzae accounted for 12.2% of nasopharyngeal cultures obtained during well visits and Moraxella catarrhalis was isolated in 34.9% of the cultures.
Of the nasopharyngeal cultures taken at onset of AOM, approximately 48% were positive for S. pneumoniae compared with 28.7% found in middle ear cultures; 42% were non-typeable H. influenzae compared with 37% found in middle ear cultures; 47.4% were identified as M. catarrhalis, either isolated or in combinations, compared with 19.6% in the middle ear fluid group.
Based on these results, researchers observed that nasopharyngeal cultures obtained during well visits had little predicative value for otopathogen mix or antibiotic susceptibility patterns at onset of AOM. Further, nasopharyngeal cultures obtained during well visits were not considered strong predictors of results from middle ear fluid cultures.
“Nasopharyngeal cultures at onset of AOM more closely correlated with otopathogen mix and antibiotic susceptibility of middle ear fluid cultures, but the correlation was too low to allow nasopharyngeal cultures to be recommended as a substitute for middle ear fluid cultures for epidemiologic value. Only tympanocentesis cultures reflect middle ear pathogens,” the researchers wrote.
For more information:
Kaur R. Abstract G-289. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 5-9, 2014; Washington, D.C.
Disclosure: The researchers report no relevant financial disclosures.