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Pediatr Infect Dis J. 2018 Dec 3. doi: 10.1097/INF.0000000000002254. [Epub ahead of print]

Etiology of Childhood Otorrhea in Luanda, Angola, and a Review of Otitis Media in African Children.

Author information

1
Children's Hospital, Helsinki University Hospital, Helsinki, Finland and University of Helsinki, Helsinki, Finland.
2
Pediatric Research Center, Helsinki, Finland.
3
David Bernardino Children's Hospital, Luanda, Angola.
4
Laboratory of Microbiology, David Bernardino Children's Hospital, Luanda, Angola.
5
Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, HUSLAB, Helsinki, Finland.
6
Department of Otorhinolaryngology, Helsinki University Hospital, Helsinki, Finland.

Abstract

BACKGROUND:

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.

METHODS:

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 to data from other studies among African children through a literature review of 20 papers published over two decades.

RESULTS:

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 sp was the most common (n = 158, 29%), followed by Proteus sp (n = 134, 25%). Among Staphylococcus aureus (n = 106, 10%), 69% of tested isolates were MRSA, and among Enterobacteriaceae 14% were ESBL 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 (CSOM) in children as well as possible gaps in existing knowledge.

CONCLUSIONS:

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.

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