MICROBIOLOGICAL STUDY OF PERSISTENT MIDDL E-EAR EFFUSION IN CHILDREN LIVING IN WEST-AFRICA

Background. - Haemophilus influenzae and S pneumoniae are the most com mon causative agents of acute otitis media in Europe and the USA. This work aimed to identify the agents in Senegal and to study their sensi tivity to antibiotics. Population and methods. - Two hundred and one p atients, aged 0 to 15 years, with persistent middle-ear effusion, were included in this study from 1983 to 1993. Purulent samples aspirated from the external canal were analysed for bacteriology and sensitivity testing. Results. - Eighty two percent of cultures were positive for Staphylococcus aureus (37%), Pseudomonas aeruginosa (25%), Proteus (18 %) and Klebsiella (8%). Positive cultures were found mainly in childre n aged between 1 and 5 years. Amikacin and cefotaxim were the most act ive antibiotics against the majority of strains. Staphylococcus aureus was always resistant to penicillin. Conclusions. - Prevalence of Stap hylococcus aureus as the causative agent of persistent middle-ear effu sion may be explained by late examination. Its resistance to penicilli n favors early administration of third generation cephalosporins or pr istanimycin.