From the Department of Pediatrics, Children's Hospital, Helsinki University Hospital.
University of Helsinki.
Pediatr Infect Dis J. 2019 Jun;38(6):577-581. doi: 10.1097/INF.0000000000002254.
In resource-poor settings, otorrhea causes a significant burden of disease in children. Etiologic studies and structured data on otorrhea and chronic otitis media among African children remain scarce.
Here, we reviewed 678 bacteriologically analyzed otorrhea samples from Luanda Children's Hospital from children ≤15 years of age between 2008 and 2015. We then compared these with data from other studies among African children through a literature review of 20 articles published over 2 decades.
Overall, 32 different bacteria were identified among 542 isolates from 654 children in Luanda. Gram-negative bacteria constituted the majority of all isolates (85%), whereby Pseudomonas spp. was the most common (n = 158; 29%), followed by Proteus spp. (n = 134; 25%). Among Staphylococcus aureus (n = 54; 10%), 69% of tested isolates were Methicillin-resistant S. aureus, and among Enterobacteriaceae, 14% were expanded-spectrum β-lactamase isolates. Resistance to quinolones was rare. Furthermore, in a review of the literature, we found a high occurrence of otorrhea and chronic suppurative otitis media in children as well as possible gaps in existing knowledge.
In Angola, Gram-negative rods emerged as common causative agents of otorrhea in children followed by S. aureus. The magnitude of chronic otorrhea in Africa represents a cause for public health concern.
在资源匮乏的环境中，耳漏给儿童带来了巨大的疾病负担。在非洲儿童中，关于耳漏和慢性中耳炎的病因学研究和结构化数据仍然很少。
在这里，我们回顾了 2008 年至 2015 年期间，罗安达儿童医院 678 例经细菌分析的耳漏样本，这些样本来自 15 岁以下的儿童。然后，我们通过对过去 20 年发表的 20 篇文章进行文献回顾，将这些数据与其他非洲儿童研究的数据进行了比较。
总体而言，在罗安达的 654 名儿童的 542 个分离株中鉴定出 32 种不同的细菌。革兰氏阴性菌构成了所有分离株的大多数（85%），其中铜绿假单胞菌最常见（n = 158；29%），其次是普罗维登斯菌（n = 134；25%）。在金黄色葡萄球菌（n = 54；10%）中，69%的测试分离株为耐甲氧西林金黄色葡萄球菌，在肠杆菌科中，14%为扩展谱β-内酰胺酶分离株。对喹诺酮类药物的耐药性很少见。此外，在文献综述中，我们发现儿童耳漏和慢性化脓性中耳炎的发生率很高，而且现有知识可能存在差距。
在安哥拉，革兰氏阴性杆菌是儿童耳漏的常见病原体，其次是金黄色葡萄球菌。非洲慢性耳漏的严重程度令人担忧。
