Background: Non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae are major causes of\r\nbacterial acute otitis media (AOM). Data regarding AOM are limited in Latin America. This is the first active\r\nsurveillance in a private setting in Venezuela to characterize the bacterial etiology of AOM in children < 5 years of\r\nage.\r\nMethods: Between December 2008 and December 2009, 91 AOM episodes (including sporadic, recurrent and\r\ntreatment failures) were studied in 87 children enrolled into a medical center in Caracas, Venezuela. Middle ear\r\nfluid samples were collected either by tympanocentesis or spontaneous otorrhea swab sampling method. Standard\r\nlaboratory and microbiological techniques were used to identify bacteria and test for antimicrobial resistance. The\r\nresults were interpreted according to Clinical Laboratory Standards Institute (CLSI) 2009 for non-meningitis isolates.\r\nAll statistical analyses were performed using SAS 9.1 and Microsoft Excel (for graphical purposes).\r\nResults: Overall, bacteria were cultured from 69.2% (63 of the 91 episodes); at least one pathogen (S. pneumoniae,\r\nH. influenzae, S. pyogenes or M. catarrhalis) was cultured from 65.9% (60/91) of episodes. H. influenzae (55.5%; 35/63\r\nepisodes) and S. pneumoniae (34.9%; 22/63 episodes) were the most frequently reported bacteria. Among H.\r\ninfluenzae isolates, 62.9% (22/35 episodes) were non-capsulated (NTHi) and 31.4% (11/35 episodes) were capsulated\r\nincluding types d, a, c and f, across all age groups. Low antibiotic resistance for H. influenzae was observed to\r\namoxicillin/ampicillin (5.7%; 2/35 samples). NTHi was isolated in four of the six H. influenzae positive samples\r\n(66.7%) from recurrent episodes.\r\nConclusions: We found H. influenzae and S. pneumoniae to be the main pathogens causing AOM in Venezuela.\r\nPneumococcal conjugate vaccines with efficacy against these bacterial pathogens may have the potential to\r\nmaximize protection against AOM.
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