MRSA otorrhea after tympanostomy
A retrospective case-control cohort study by American scientists aimed to identify risk factors for the development of otorrhea caused by methicillin-resistant strains of Staphylococcus aureus (MRSA) after a tympanostomy.
The study included 17 patients with MRSA-induced otorrhea that developed after bilateral myringotomy with tympanostomy and 19 children of equal age with otorrhea caused by methicillin-sensitive strains of S.aureus (MSSA). During the study, a pharmacological and medical history was collected and the practice of routine antibacterial treatment of otitis media was studied.
The following statistically significant differences (p less than 0.06, Mann-Whitney test) from patients in the control group were revealed in patients with MRSA: 1) more episodes of acute otitis media before tympanostomy, 2) more courses of antibiotic therapy after tympanostomy and 3) longer duration of antibiotic therapy after the intervention.
Thus, in children with MRSA-induced otorrhea, a history of 5 times more episodes of acute otitis media was observed in the year before the procedure, they also received 2 times more treatments antibacterials. After tympanostomy, the number of episodes of acute otitis media and duration of drainage did not differ in the two groups, however, patients with otorrhea caused by MRSA received twice as many antibiotic treatments (14, 4 vs 6,7), and the duration of treatment was twice that of children with otorrhea caused by MSSA (160 days vs 67 days).
As the study results showed, otorrhea caused by methicillin-resistant strains of S.aureus often occurs in community-acquired conditions in relatively healthy immunocompetent children. Risk factors for its development include the number of episodes of acute otitis media before tympanostomy, the number of courses and the duration of antibiotic therapy after the intervention.
According to the authors of the article, the priority issue for these patients is not the treatment of infections, but preventive measures, mainly consisting in minimizing the use of systemic antibacterial drugs.