MICROBIOLOGICAL STUDY OF PERSISTENT MIDDLE-EAR EFFUSION IN CHILDREN LIVING IN WEST-AFRICA

Background. - Haemophilus influenzae and S pneumoniae are the most common causative agents of acute otitis media in Europe and the USA. This work aimed to identify the agents in Senegal and to study their sensitivity to antibiotics. Population and methods. - Two hundred and one patients, aged 0 to 15 years, with persistent middle-ear effusion, were included in this study from 1983 to 1993. Purulent samples aspirated from the external canal were analysed for bacteriology and sensitivity testing. Results. - Eighty two percent of cultures were positive for Staphylococcus aureus (37%), Pseudomonas aeruginosa (25%), Proteus (18%) and Klebsiella (8%). Positive cultures were found mainly in children aged between 1 and 5 years. Amikacin and cefotaxim were the most active antibiotics against the majority of strains. Staphylococcus aureus was always resistant to penicillin. Conclusions. - Prevalence of Staphylococcus aureus as the causative agent of persistent middle-ear effusion may be explained by late examination. Its resistance to penicillin favors early administration of third generation cephalosporins or pristanimycin.