Van Hare G F, Shurin P A, Marchant C D, Cartelli N A, Johnson C E, Fulton D, Carlin S, Kim C H
Rev Infect Dis. 1987 Jan-Feb;9(1):16-27. doi: 10.1093/clinids/9.1.16.
Since 1980, we have observed an epidemic of otitis media caused by Branhamella catarrhalis. This event was characterized by studying the nasopharyngeal colonization of infants and children with B. catarrhalis and the clinical presentation and therapeutic outcome of acute otitis media caused by this organism. Pharyngeal colonization with B. catarrhalis was commoner in winter than summer. B. catarrhalis was present in middle-ear fluid (MEF) of 17% of children with otitis media, and was commoner in fall and winter (20%) than in spring and summer (11%, P less than .05). Seventy-five percent of isolates produced beta-lactamase (Ravasio type). In five of 20 patients, treatment with beta-lactamase-susceptible agents failed to sterilize B. catarrhalis-infected MEF. All of these five patients were infected with beta-lactamase-producing strains. The increasing prominence of antibiotic-resistant B. catarrhalis in acute otitis media may lead to a reevaluation of initial antibiotic therapy for acute otitis media, particularly in winter or in areas where colonization with such strains is prevalent.
自1980年以来，我们观察到了由卡他莫拉菌引起的中耳炎流行。这一事件的特点是研究了感染卡他莫拉菌的婴幼儿的鼻咽部定植情况以及由该菌引起的急性中耳炎的临床表现和治疗结果。卡他莫拉菌在咽部的定植在冬季比夏季更为常见。在17%的中耳炎患儿的中耳积液（MEF）中发现了卡他莫拉菌，且在秋冬季节（20%）比春夏季节（11%，P<0.05）更为常见。75%的分离株产生β-内酰胺酶（拉瓦西奥型）。在20例患者中的5例中，使用对β-内酰胺酶敏感的药物治疗未能清除感染卡他莫拉菌的中耳积液。这5例患者均感染了产β-内酰胺酶的菌株。急性中耳炎中耐药卡他莫拉菌日益突出，这可能会促使人们重新评估急性中耳炎的初始抗生素治疗方案，尤其是在冬季或此类菌株定植普遍的地区。
