Magnitude of Acute Otitis Media, Bacteriological Profile and Antimicrobial Sensitivity Patterns of Nasopharyngeal Isolates in Children Receiving Care in Moshi Municipality
Background: Acute otitis media (AOM) is among the most common paediatric diseases and a leading cause of morbidity in children. Common etiologic pathogens include non-typable Haemophilus influenza, Streptococcus pneumoniae, Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa, Escherichia coli, Moraxella catarrhalis among others. Evidence shows an increase in cases of antimicrobial resistance when treating for AOM in children, which could be attributed to high rates of empirical treatment for cases of AOM without a clear microbial picture of the otopathogens responsible for the condition. Methods: Multi-centre cross-sectional study, carried out between September 2023 to February 2024 at 4 study sites in the outpatient departments. Children under 5 years presenting with AOM during the study period were enrolled. An interview was conducted with parents/caregivers followed by clinical assessment of the children. Nasopharyngeal swabs were obtained from each of these patients and sent to the laboratory for bacterial culture and sensitivity. Data was analysed using SPSS v22. Results: A total of 117 children were enrolled in the study from 420 children receiving care during the study period. The magnitude of AOM was 27.9%, with children aged between 13 to 24 months being the most susceptible. Common isolated pathogens included S. pyogenes, E. coli, Acinetobacter spp. and P. aeruginosa and S. aureus. Amikacin, Meropenem, Ciprofloxacin and Tazobactam/Piperacillin had the highest rates of susceptibility while Amoxicillin, Ampicillin, Ceftriaxone and Amoxicillin/Clavulanic acid showed high levels of resistance. Conclusion: Magnitude of AOM among children is 27.9%. Bacterial pathogens isolated from nasopharyngeal swabs are different from the common etiologic bacteria seen in AOM which could be due to good vaccination coverage of PCV and Pentavalent. Non susceptibility to the commonly used antibiotics indicates the growing rate of antimicrobial resistance. Better pathogen-tailored therapy needs to be implemented to help curb this burden, as well as further investigations on the rising etiologic pathogen.
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