Particularities of bacterial ecology of acute otitis media in an African subtropical country (Cote d’Ivoire)

Acute otitis media (AOM) is the commonest infectious disease of childhood. Its treatment is based on a probabilistic antibiotic therapy. To determine the prevalence of different bacteria responsible for AOM in children in Abidjan (Côte d’Ivoire). This is a prospective study, between November 2002 and August 2003. To identify bacterial isolates, 60 children under 15 years old with AOM were enrolled. In 52 cases, the sample was recovered by aspiration of a spontaneous otorrhea and in eight cases, it was taken by paracentesis. Nasopharyngeal swabs were cultured. Antibiotic susceptibility tests were performed on isolates. 75% of children were under 24 months of age. Pseudomonas aeruginosa was recovered in 31.8% of cases followed by Streptococcus pneumoniae (21%), Proteus (7.4%) and Staphylococcus (6.2%). The rate of penicillin-nonsusceptible S. pneumoniae (NSSP) was 11.8%. Resistance to erythromycin was 6%. For Pseudomonas, resistances to antibiotics were 35.5% to ceftazidim and 16% to pefloxacin, respectively, but all the strains were sensible to colistin, iminepem and ciprofloxacin. These data can modify therapeutic approaches for treatment of AOM in our country. This study should encourage surveillance of AOM microbiology.