NASOPHARYNGEAL COLONISATION AND RESISTANCE OF STREPTOCOCCUS PNEUMONIAE, MORAXELLA CATARRHALIS AND HAEMOPHILUS INFLUENZAE IN PRE-SCHOOL CHILDREN WITH DIAGNOSIS OTITIS MEDIA ACUTA

Abstract

Nazofaringealna kolonizacija humanopatogenim bakterijama preduvjet je za razvoj akutnog otitisa media (AOM). Većina autora danas se slaže s mišljenjem da pozitivan bakteriološki nalaz iz obriska nazofarinksa (NF) ima klinički značaj. Ubrzani porast rezistencije ovih bakterija na antibiotike komplicira dosadašnju empirijsku terapiju ovih infekcija u mnogim zemljama. Cilj ovog istraživanja bio je odrediti učestalost i rezistenciju pojedinih patogenih izolata iz obriska NF-a djece predškolske dobi s uputnom dijagnozom rhinopharyngitis acuta i AOM. Cilj istraživanja bio je i pokazati da dosadašnja preporučena empirijska terapija ovih infekcija amoksicilinom nije bakteriološki opravdana. Od ukupnog broja obrisaka NF-a (1229), 468 uzoraka bilo je bakteriološki pozitivno (38,08%). Od ukupnog broja pozitivnih nalaza u 40,60% izoliran je pneumokok, u 40,17% M. catarrhalis, u 15,17% H. influenzae, a u 4,06% izolirani su BHS-A, C ili G. Rezultati našeg istraživanja pokazuju da je najviša rezistencija najčešćeg izolata - pneumokoka bila na penicilin i amoksicilin ( 37,37%). Empirijska terapija određene infekcije određenim antibiotikom moguća je samo ako rezistencija najčešćeg uzročnika na taj antibiotik u određenoj populaciji ne prelazi 15%. Zaključak ovog istraživanja je da u empirijskoj terapiji navedenih infekcija u našoj regiji više nije mjesto penicilinu ni amoksicilinu.Nasopharyngeal colonisation with human pathogenic bacteria is a prerequisite for the development of otitis media acute (OAM). Most authors agree that bacterial isolation from nasopharyngeal secretion has clinical signficance. The continuing increase in resistance to commonly used antibiotics makes treatment of these infections difficult in many countries. The purpose of this report was to determine the incidence and resistance in nasopharyngeal isolates in pre-school children with the diagnosis of Rhinopharyngitis acuta and Otitis media acuta. The objective of this study was to show that usually empiric antibiotic therapy with amoxicillin is not justified. From the total number of nasopharyngeal samples (1229), 468 had a positive bacteriological result (38.08%). Pneumococcus was isolated from 40.60% samples, Moraxella catarrhalis from 40.17%, Haemophilus influenzae from 15.17% samples and from 4.06% samples was isolated BHS-A, C or G. Our results show highly resistance of first isolate - Pneumococcus on penicillin and amoxicillin ( 37.37% ). Empiric therapy of a particular infection with a particular antibiotic is possible only if the antibiotic resistance to the common cause is under 15 % in a particular population. The conclusion of this paper is that there is no reason for using penicillin and amoxicillin in empiric therapy for specified infections in our region