{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:05:51Z","timestamp":1789239951467,"version":"build-2803163510"},"reference-count":16,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Princ Pract"],"published-print":{"date-parts":[[2021]]},"abstract":"<b><i>Objectives:<\/i><\/b> <i>Streptococcus pneumoniae<\/i> is the leading bacterial etiologic agent in acute otitis media (AOM), and it produces a more severe inflammatory response than other otopathogens. Additionally, the presence of multidrug-resistant (MDR) <i>S. pneumoniae<\/i> is an important issue in the management of AOM. The present pilot study aimed to ascertain whether MDR <i>S. pneumoniae<\/i> is associated with a higher inflammatory response and\/or a more severe disease. <b><i>Methods:<\/i><\/b> This was a prospective, single-center study on nonpneumococcal conjugate vaccine-immunized pediatric patients with severe AOM. Demographic and clinical characteristics were recorded. Middle ear fluid was obtained and cultured for each patient; antibiotic-resistance profiling was tested for <i>S. pneumoniae<\/i> isolates. The C-reactive protein (CRP) level and complete blood count were determined. Patients with positive middle ear fluid culture for <i>S. pneumoniae<\/i> were divided into 2 groups according to antibiotic resistance profile: MDR and non-MDR. <b><i>Results:<\/i><\/b> MDR <i>S. pneumoniae<\/i> was identified in 15 (35.7%) of the 42 eligible patients. Children in this group had significantly higher CRP levels (72.23 \u00b1 62.92 vs. 14.96 \u00b1 15.57 mg\/L, <i>p<\/i> &#x3c; 0.001), higher absolute neutrophil count (8.46 \u00b1 3.97 vs. 5.22 \u00b1 4.5 \u00d7 10<sup>3<\/sup>\/mm<sup>3<\/sup>, <i>p<\/i> = 0.004), higher percentage of neutrophils (52.85 \u00b1 13.49% vs. 38.34 \u00b1 16.16%, <i>p<\/i> = 0.004), and were more prone to develop acute mastoiditis (<i>p<\/i> = 0.01). Receiver operating characteristic analysis identified CRP as the best biomarker to discriminate between the 2 groups of patients (AUC = 0.891). <b><i>Conclusion:<\/i><\/b> MDR <i>S. pneumoniae<\/i> was associated with a more severe inflammatory response and a higher incidence of mastoiditis. <\/jats:p>","DOI":"10.1159\/000518720","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T21:01:20Z","timestamp":1627592480000},"page":"571-578","source":"Crossref","is-referenced-by-count":7,"title":["Is Multidrug Resistance in Acute Otitis Media with <b><i>Streptococcus pneumoniae<\/i><\/b> Associated with a More Severe Disease?"],"prefix":"10.1159","volume":"30","author":[{"given":"Raluca","family":"Horhat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin-Raul","family":"Horhat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-9962","authenticated-orcid":false,"given":"Valeria","family":"Mocanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jegh.2014.03.002"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.GPP3-0004-2018"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0150949"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2016.08.002"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12384"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199503000-00003"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.10.045"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens9050362"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S276975"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.8.2814-2818.2000"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1098-2825(1998)12:3%3c137::aid-jcla2%3e3.0.co;2-6"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2020.1783570"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d3082"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1086\/528685"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-72264-4"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.02724.x"}],"container-title":["Medical Principles and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/518720","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/518720","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:18:48Z","timestamp":1745421528000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000518720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":16,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,12,16]]},"published-print":{"date-parts":[[2022,1,6]]}},"URL":"https:\/\/doi.org\/10.1159\/000518720","archive":["Portico"],"relation":{},"ISSN":["1011-7571","1423-0151"],"issn-type":[{"value":"1011-7571","type":"print"},{"value":"1423-0151","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]}}}