Bacteriological Evaluation of Children With Otorrhea

Официальное название

Bacteriological Evaluation of Spontaneous Otorrhea in Children

Обзор

After pneumococcal conjugate vaccine implementation, the number of acute otitis media (AOM) episodes has decreased, but AOM still remains among the most common diagnoses in childhood. From 2% to 17% of cases of AOM feature spontaneous perforation of the tympanic membrane (SPTM). The aim of this study was to describe the bacteriological causes of SPTM several years after PCV13 implementation, in 2010.

Подробное описание

Since October 2015, children with spontaneous perforation of the tympanic membrane (SPTM) are prospectively enrolled by 20 pediatricians who are part of a research and teaching network (ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne \[Clinical and Therapeutic Association of Val de Marne\]) throughout France. For some patients, otorrhea is the first manifestation of AOM; for others, otorrhea occurred after AOM treatment failure or recurrence. Failure (non-responsive AOM) is defined as otorrhea appearing despite at least 48 hr of antibiotics or recurring less than 4 days after the end of antibiotic treatment. Recurrence is defined by the appearance of otorrhea 4 to 30 days after the end of antibiotic treatment for AOM.

Middle ear fluid (MEF) is obtained by sampling spontaneous discharge according to clinical practice guidelines. MEF specimens are obtained with cotton-tipped wire swabs, immediately placed in transport medium (Copan Venturi Transystem®, Brescia, Italy), and transported within 48 hr to one of the two centralized microbiology laboratories (Robert Debré Hospital or National Centre for Pneumococci at European Georges Pompidou Hospital, Paris, France).

Вмешательства

• Другое middle ear fluid sample for bacterial analysis (conventional microbiology analysis)
  A middle ear fluid sample will be collected from each enrolled child for the third analysis procedure.

Первичные конечные точки

• Microbiological Profiles of Spontaneous Otorrhea in Children [Срок оценки: at inclusion]

Вторичные конечные точки (4)

• Descriptive analysis of patient characteristics according to bacteriological Profiles [Срок оценки: at inclusion]
• Clinical Characteristics of Treatment Failure or Recurrence in Children with AOM [Срок оценки: at inclusion]
• Microbiota Analysis of Spontaneous Otorrhea in Children [Срок оценки: at inclusion]
• Comparison Between Rapid Diagnostic Test (RDT) and Laboratory Results [Срок оценки: at inclusion]

Критерии участия

Критерии включения

• children from 3 months to 15 years old
• with otorrhea
• signed parents consent

Критерии исключения

• children under 3 months
• children > 15 years old

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Только случаи

Центры проведения

Франция · 1 центр

• ACTIV — Créteil

Публикации

• Levy C, Varon E, Ouldali N, Wollner A, Thollot F, Corrard F, Werner A, Bechet S, Bonacorsi S, Cohen R. Bacterial causes of otitis media with spontaneous perforation of the tympanic membrane in the era of 13 valent pneumococcal conjugate vaccine. PLoS One. 2019 Feb 1;14(2):e0211712. doi: 10.1371/journal.pone.0211712. eCollection 2019. PMID 30707730
• Assad Z, Cohen R, Varon E, Levy C, Bechet S, Corrard F, Werner A, Ouldali N, Bonacorsi S, Rybak A. Antibiotic Resistance of Haemophilus influenzae in Nasopharyngeal Carriage of Children with Acute Otitis Media and in Middle Ear Fluid from Otorrhea. Antibiotics (Basel). 2023 Nov 8;12(11):1605. doi: 10.3390/antibiotics12111605. PMID 37998807
• Levy C, Varon E, Bidet P, Bechet S, Batard C, Wollner A, Thollot F, Bonacorsi S, Cohen R. Otorrhea bacterial profile, epidemiology before widespread use of the third-generation pneumococcal conjugate vaccine in French children, a prospective study from 2015 to 2023. Infect Dis Now. 2023 Sep;53(6):104738. doi: 10.1016/j.idnow.2023.104738. Epub 2023 Jun 17. PMID 37331698
• Cohen R, Varon E, Bidet P, Cohen JF, Bechet S, Couloigner V, Michot AS, Guiheneuf C, Bonacorsi S, Levy C. Diagnostic Accuracy of Group A Streptococcus Rapid Antigen Detection Test on Middle Ear Fluid in Children With Acute Otitis Media With Spontaneous Perforation: A Prospective Multicenter Evaluation. Pediatr Infect Dis J. 2023 Sep 1;42(9):816-818. doi: 10.1097/INF.0000000000004009. Epub 2023 Jun PMID 37368992

Идентификаторы

NCT: NCT04807660 · ACT0315

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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