Microbiology of otitis media in the Paris, France, area from 1987 to 1997

Purpose of the study. To investigate epidemiologic trends in the bacteriolo gy of acute otitis media, data were recorded during a 10-year period by the same group of investigators during clinical studies in pediatric outpatien ts. Methods. Bacterial samples were obtained before antibiotic treatment from 2 149 children (age 3 to 36 months) with acute otitis media. All samples were transported, handled and cultured in the same way throughout the 10-year p eriod. Results. From the study patients 1862 samples of middle ear secretion were collected by tympanocentesis and 287 samples were collected from spontaneou s otorrhea occurring within 24 h. Pathogens were isolated from 70% of patie nts. Pathogens included Haemophilus influenzae (40%), Streptococcus pneumon iae (31%) and Moraxella catarrhalis (8%). The incidence of beta-lactamase-p roducing H. influenzae was similar to 20% from 1987 to 1989, was similar to 35% from 1990 to 1995 and increased to 60 and 70% during the last 2 years. The rate of S. pneumoniae with decreased susceptibility to penicillin grad ually increased from 7% in 1987 to 70% in 1996 and 1997. Conclusion. The very high incidence of antimicrobial resistant strains reac hed during a short period in pediatric acute otitis media in our area, emph asizes the need for frequent epidemiologic studies.