Open AccessIncidence Survey of Acute Otitis Media in Children in Sado Island, Japan—Sado Otitis Media Study (SADOMS)
Author(s) -
Taketo Otsuka,
Osamu Kitami,
Kouji Kondo,
Hisayuki Ota,
Shinsuke Oshima,
Akio Tsuchiya,
Takatoshi Shirai,
Koyata Fujii,
Michihide Nakamure,
Yasuhiro Shoji,
Hisano Nakamura,
Yasuko Masuda,
Kenichi Komiyama,
Kimihiko Yoshida,
Yukio Ishikawa,
Atsushi Iwaya,
Sugata Takahashi,
Masanori Okazaki,
Muneki Hotomi,
Noboru Yamanaka
Publication year - 2013
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0068711
Subject(s) - medicine , incidence (geometry) , streptococcus pneumoniae , haemophilus influenzae , pediatrics , population , otitis , epidemiology , serotype , ear infection , surgery , immunology , antibiotics , microbiology and biotechnology , physics , environmental health , audiology , optics , biology
Background Acute otitis media (AOM) is one of the most common forms of bacterial infection and cause for clinic visits in children. The incidence of AOM was 0.9–1.2 episodes per person-year during the first 2 years of life in previous reports conducted before 2000. The aim of this study was to 1) evaluate the latest AOM incidence in pediatric outpatients and 2) identify the bacterial pathogens from these patients and ascertain their serotypes and resistance. Methods The study was conducted in a closed population, involving all pediatricians and otolaryngologists in Sado Island allowing accurate determination of AOM incidence. In each month, one week was assigned as “surveillance week”, and all outpatients with acute illness aged 0–18 years examined during the surveillance weeks were enrolled. AOM was diagnosed on the basis of otoscopic findings and clinical symptoms were recorded. Specimens were collected from the nasopharynx or middle ear cavity of AOM patients and examined for bacteria. Antimicrobial susceptibilities, serotypes, and molecular typing for resistance were determined among Streptococcus pneumoniae and Haemophilus influenzae.Results In total, 8,283 clinic visits were conducted, and 354 episodes (4.3%, 95% CI: 3.9–4.7%) among 312 children were diagnosed as AOM. The incidence of AOM was highest in children of 1 year of age (0.54 episodes/child/year, 95% CI: 0.44–0.64). Serotype coverage of 7- and 13-valent pneumococcal conjugate vaccines in this study were 38.0% (95% CI: 29.3–47.3) and 62.8% (95% CI: 53.6–71.4), respectively. Of 122 H.influenzae isolates available for typing, 120 were nontypeable and 2 were type b. A high proportion of S. pneumoniae isolates (46%) showed resistance to penicillin. Approximately half of H. influenzae isolates had genetic markers for beta-lactamase-negative ampicillin-resistance. Conclusions Approximately 4–5% of pediatric outpatients, even without AOM-related symptoms, had AOM in our study. Pediatricians as well as otolaryngologists should check the tympanic membrane findings of all pediatric outpatients.