NOSOCOMIAL STREPTOCOCCUS-PNEUMONIAE INFECTION CAUSING CHILDRENS ACUTEOTITIS-MEDIA

Streptococcus pneumoniae is the most frequent pathogen in young childr en's acute otitis media, It also plays a significant role in nosocomia l ear infection in children, while it causes pneumonia with or without bacteremia in hospitalized elderly people. Multiple antibiotic resist ant strains are prevalent among S. pneumoniae isolates from the respir atory tract of hospitalized patients in Hungary. This fact makes thera peutic reconsiderations concerning the use of oral beta-lactams mandat ory. In this retrospective study two nosocomial outbreaks caused by mu ltiresistant S. pneumoniae in two pediatric hospitals are described. T he patients admitted with a chronic underlying disease (milk intoleran ce and gastro-oesophageal reflux were predominant) or respiratory trac t infection acquired acute otitis media. Therapy with oral beta-lactam s (first and second generation cephalosporins and amoxicillin), macrol ides and co-trimoxazole was ineffective in most of the cases or result ed in transient improvement. In some cases acute otitis media resolved with the improvement of the underlying condition, in two cases admini stration of cefotaxime resulted in recovery and in one case mastoidect omy became necessary. (C) 1997 Elsevier Science B.V.