Pediatria pre prax S3/2010

Microbiological aspects of otitis media acuta in children in Slovak republic

The work presents studies surveying the trends in the serotype resistance and distribution of S. pneumoniae strains with otitis media acuta (AOM) with children in the years 1999, 2006 and 2009. In 1999, 35,9 % of penicillin-insensitive S. pneumoniae strains were isolated and 64,1 % of the strains insensitive to macrolides, in 2006, it was 40,8 % of the strains insensitive to penicillin and 47,5 % to macrolides and in 2009 there were 38,1 % of the strains insensitive to penicillin and 40,9 % to macrolides. In the period the nationwide vaccination with the conjugated 7-valent vaccine has been introduced, the most frequently isolated serotype was 23F. In the recent times we recorded an increase of the serotypes 3, 19A and 19F. The study-results show the need for a relevant treatment of pneumococcal infections with penicillin-based antibiotics. Pharmacodynamic and pharmacokinetic studies prefer aminopenicillins in the treatment of pneumococcal infections, which in high dosage inhibit pneumococci with a reduced sensitivity to penicillin. It is necessary to prospectively monitor AOM in children, simultaneously with a surveillance of antibioticsresistance trends as well as the occurrence of pneumococcal serotypes following the introduction of new vaccines into medical routine.

Keywords: Streptococcus pneumoniae, resistance, serotype distribution.