Incidence Survey of Acute Otitis Media in Children in Sado Island, Japan-Sado Otitis Media Study (SADOMS)
Incidence Survey of Acute Otitis Media in Children in Sado Island, Japan-Sado Otitis Media Study (SADOMS)
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DOI：
10.1371/journal.pone.0068711
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发表时间：
2013-07-02
期刊：
影响因子：
3.7
通讯作者：
Yamanaka, Noboru
中科院分区：
文献类型：
--
作者：
Otsuka, Taketo;Kitami, Osamu;Yamanaka, Noboru
背景：急性中耳炎（AOM）是儿童最常见的细菌感染和临床就诊的原因之一。在2000年之前进行的既往报告中，在生命的前2年期间，AOM的发生率为0.9-1.2次/人-年。本研究的目的是1）评估最新的AOM发病率在儿科门诊和2）确定这些患者的细菌病原体，并确定其血清型和resistance.Methods：这项研究是在一个封闭的人群中进行的，涉及所有的儿科医生和耳鼻喉科医生在佐渡岛允许准确测定AOM的发病率。每月指定一周为“监测周”，所有在监测周内检查的0-18岁急性疾病门诊患者均入组。根据耳镜检查结果诊断AOM，并记录临床症状。从AOM患者的鼻咽或中耳腔收集标本并检查细菌。结果：共进行了8,283次临床访问，312名儿童中有354例（4.3%，95%CI：3.9-4.7%）被诊断为AOM。AOM在1岁儿童中的发生率最高（0.54次/儿童/年，95% CI：0.44-0.64）。本研究中7价和13价肺炎球菌结合疫苗的血清型覆盖率分别为38.0%（95%CI：29.3-47.3）和62.8%（95%CI：53.6-71.4）。在122 H. 120株为无法分型，2株为B型。高比例的S.肺炎分离株（46%）对青霉素耐药。约为H的一半。结论：在我们的研究中，大约4-5%的儿科门诊患者，即使没有AOM相关症状，也有AOM。儿科医生和耳鼻喉科医生应该检查所有儿科门诊患者的鼓膜结果。
Background: Acute otitis media (AOM) is one of the most common forms of bacterial infection and cause for clinic visits in children. The incidence of AOM was 0.9-1.2 episodes per person-year during the first 2 years of life in previous reports conducted before 2000. The aim of this study was to 1) evaluate the latest AOM incidence in pediatric outpatients and 2) identify the bacterial pathogens from these patients and ascertain their serotypes and resistance.Methods: The study was conducted in a closed population, involving all pediatricians and otolaryngologists in Sado Island allowing accurate determination of AOM incidence. In each month, one week was assigned as "surveillance week", and all outpatients with acute illness aged 0-18 years examined during the surveillance weeks were enrolled. AOM was diagnosed on the basis of otoscopic findings and clinical symptoms were recorded. Specimens were collected from the nasopharynx or middle ear cavity of AOM patients and examined for bacteria. Antimicrobial susceptibilities, serotypes, and molecular typing for resistance were determined among Streptococcus pneumoniae and Haemophilus influenzae.Results: In total, 8,283 clinic visits were conducted, and 354 episodes (4.3%, 95% CI: 3.9-4.7%) among 312 children were diagnosed as AOM. The incidence of AOM was highest in children of 1 year of age (0.54 episodes/child/year, 95% CI: 0.44-0.64). Serotype coverage of 7- and 13-valent pneumococcal conjugate vaccines in this study were 38.0% (95% CI: 29.3-47.3) and 62.8% (95% CI: 53.6-71.4), respectively. Of 122 H. influenzae isolates available for typing, 120 were nontypeable and 2 were type b. A high proportion of S. pneumoniae isolates (46%) showed resistance to penicillin. Approximately half of H. influenzae isolates had genetic markers for beta-lactamase-negative ampicillin-resistance.Conclusions: Approximately 4-5% of pediatric outpatients, even without AOM-related symptoms, had AOM in our study. Pediatricians as well as otolaryngologists should check the tympanic membrane findings of all pediatric outpatients.