Acute mastoiditis in children under 15 years of age in Southern Israel following the introduction of pneumococcal conjugate vaccines: A 4-year retrospective study (2009-2012)

作者：Kordeluk Sofia; Orgad Ran; Kraus Mordechai; Puterman Moshe; Kaplan Daniel M; Novak Lena; Dagan Ron; Leibovitz Eugene^*

来源：International Journal of Pediatric Otorhinolaryngology, 2014, 78(10): 1599-1604.

DOI：10.1016/j.ijporl.2014.07.003

• Mastoiditis
• Children
• S. pneumoniae
• Vaccines

Objectives: To describe the epidemiologic, microbiologic, clinical and therapeutic aspects of acute mastoiditis (AM) in children %26lt;15 years of age during the 4-year period (2009-2012) following the introduction of pneumococcal conjugate vaccines in Israel. %26lt;br%26gt;Patients and methods: The medical records of all children with a discharge diagnosis of AM were reviewed. %26lt;br%26gt;Results: A total of 66 AM episodes occurred in 61 patients. Forty-four (66.6%) cases occurred among patients %26lt;4 years, recent acute otitis media (AOM) history was reported in 27.1% and 28.8% patients received previous antibiotics for AOM. Postauricular swelling, postauricular sensitivity, protrusion of auricle and postauricular edema (93.8%, 90.6%, 85.9% and 95.7%, respectively) were the most common signs of AM. Leukocytosis %26gt;15 000 WBC/mm(3) was found in 39 (59.1%) cases. Cultures were performed in 52/66 episodes (positive in 27, 51.92% episodes), with recovery of 32 pathogens. The most frequently isolated pathogens were Streptococcus pneumoniae (15/52, 28.85%), Streptococcus pyogenes (9, 17.3%) and nontypeable Haemophilus influenzae (5, 9.62%). Eight (533%) S. pneumoniae isolates were susceptible to penicillin. Mean incidence of overall and pneumococcal AM were 11.1 and 2.58 cases/100 000, with no significant changes during the study years. Surgical intervention was required in 19 (28.8%) patients. %26lt;br%26gt;Conclusions: (1) AM occurs frequently in patients without previous AOM history and with no previous antibiotic treatment; (2) S. pneumoniae and S. pyogenes continued to be the main etiologic agents of AM during the postvaccination period; (3) No changes were recorded in overall AM incidence and in pneumococcal AM incidence during the postvaccination period.

• 出版日期2014-10