Coronell-Rodriguez Wilfrido, Camerano Rosanna, Alvarado-Gonzalez Juan Carlos, Puerto Alejandra, Zakzuk Josefina, Alvis-Zakzuk Nelson R, Moyano-Tamara Lina, Medina Sebastian, Beltran Claudia, Betancur Maria, Rojas Monica, Farias Luis Enrique, Pinzon-Redondo Hernando, Villamor Perla, Osorio Steven, Alvis-Guzmán Nelson
Universidad de Cartagena, Cartagena, Colombia.
ALZAK, Cartagena, Colombia.
PLoS One. 2025 Jul 28;20(7):e0326660. doi: 10.1371/journal.pone.0326660. eCollection 2025.
Since the introduction of the pneumococcal conjugate vaccine PCV-10 in 2011 its impact on acute otitis media (AOM) in children under five years of age in Colombia was unknown. We aimed to describe the clinical and sociodemographic characteristics of a prospective cohort of patients between 3 and 59 months old attending a children's hospital in Cartagena, Colombia.
A prospective cohort study was conducted over a 12-month period from August 5th, 2022 to August 5th, 2023. Diagnosis of AOM was confirmed by an otorhinolaryngologist. Middle ear fluid samples were obtained by swab or tympanocentesis, depending on the presence of spontaneous drainage. Samples with a positive culture for S. pneumoniae were sent to the Colombian National Health Institute for serotyping. We also estimated the prevalence of AOM caused by S. pneumoniae, the serotype distribution and antimicrobial resistance patterns.
A total of 61 patients were enrolled, 58% were male, the median age was 12 months (IQR: 8-24). The most common isolated microorganisms were Pseudomonas aeruginosa (14.8%), methicillin-resistant Staphylococcus aureus (13.1%), and Streptococcus pneumoniae (9,8%). Six cases of S. pneumoniae were identified, median age was 26.5 months (IQR: 8-45), none had any comorbidities, and only one had a history of previous AOM episodes. Five of them were vaccinated. The serotype distribution was 19A (67%), 10F and 35A (17%) each. Within the antimicrobial resistance patterns, serotype 19A was multidrug resistant (resistance to: beta-lactams, macrolides, lincosamides and TMP/SMX).
S. pneumoniae continues to be a leading cause of AOM in our country. Serotype 19A accounts for 67% of these infections and exhibits a multidrug-resistant pattern similar to that observed in invasive pneumococcal disease. These findings are consistent with international data and provide a baseline for tracking future AOM trends related to S. pneumoniae after the introduction of the PCV-13 vaccine.
自2011年引入肺炎球菌结合疫苗PCV - 10以来，其对哥伦比亚5岁以下儿童急性中耳炎（AOM）的影响尚不清楚。我们旨在描述哥伦比亚卡塔赫纳一家儿童医院中3至59个月大的前瞻性队列患者的临床和社会人口学特征。
在2022年8月5日至2023年8月5日的12个月期间进行了一项前瞻性队列研究。AOM的诊断由耳鼻喉科医生确认。根据是否存在自发引流，通过拭子或鼓膜穿刺术获取中耳液样本。肺炎链球菌培养阳性的样本被送往哥伦比亚国家卫生研究所进行血清分型。我们还估计了由肺炎链球菌引起的AOM的患病率、血清型分布和抗菌药物耐药模式。
共纳入61例患者，58%为男性，中位年龄为12个月（四分位间距：8 - 24）。最常见的分离微生物是铜绿假单胞菌（14.8%）、耐甲氧西林金黄色葡萄球菌（13.1%）和肺炎链球菌（9.8%）。鉴定出6例肺炎链球菌病例，中位年龄为26.5个月（四分位间距：8 - 45），均无任何合并症，只有1例有既往AOM发作史。其中5例接种过疫苗。血清型分布为19A（67%），10F和35A各占17%。在抗菌药物耐药模式方面，19A血清型对多种药物耐药（对β - 内酰胺类、大环内酯类、林可酰胺类和复方磺胺甲恶唑耐药）。
肺炎链球菌仍然是我国AOM的主要病因。19A血清型占这些感染的67%，并表现出与侵袭性肺炎球菌疾病中观察到的类似的多重耐药模式。这些发现与国际数据一致，并为在引入PCV - 13疫苗后追踪未来与肺炎链球菌相关的AOM趋势提供了基线。
