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The microbiology of acute mastoiditis infections presenting to a large UK tertiary paediatric ENT centre in a post-pneumococcal conjugate vaccination era

Published online by Cambridge University Press:  25 October 2024

Nathan Richard Walker Open the ORCID record for Nathan Richard Walker [Opens in a new window] ,
Sarah Mortaja ,
Aikaterini Eleftheriadou  and
Sunil Sharma
Nathan Richard Walker*
Affiliation:
Department of Otolaryngology, Alder Hey Children’s Hospital, Liverpool, UK
Sarah Mortaja
Affiliation:
Department of Otolaryngology, Alder Hey Children’s Hospital, Liverpool, UK
Aikaterini Eleftheriadou
Affiliation:
Department of Otolaryngology, Alder Hey Children’s Hospital, Liverpool, UK
Sunil Sharma
Affiliation:
Department of Otolaryngology, Alder Hey Children’s Hospital, Liverpool, UK
*
Corresponding author: Nathan Richard Walker; Email: nathan.walker2@nhs.net
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Abstract

Objectives

Mastoiditis commonly presents to ENT services. Following the UK introduction of the 13-valent conjugate pneumococcal vaccine in 2010, changes in the organisms of these infections were hypothesised. We aim to assess the microbiological profile of patients with acute mastoiditis in our centre.

Methods

Retrospective review of patients admitted to Alder Hey Children’s Hospital for mastoiditis between January 2017–September 2022. Data was collected from electronic patient records, microbiology and biochemistry reports.

Results

A total of 108 patients were admitted: 61 males and 47 females with a median age of 2 years (with a range of 4 months–14 years). A total of 82 organisms were isolated from 50 (46 per cent) children. Streptococcus spp. (22 specimens; 27 per cent) and Staphylococcus spp. (13 specimens; 16 per cent) were most common. Other organisms included Pseudomonas aeruginosa (6; 7 per cent), anaerobes (4; 5 per cent), Haemophilus influenzae (4; 5 per cent), and Fusobacterium (4; 6 per cent).

Conclusion

Mastoiditis predominantly involves gram-positive, facultative anaerobic bacteria. Empirical cefotaxime and metronidazole provide adequate coverage. Culture and sensitivity testing is essential for antibiotic stewardship.

Keywords

mastoiditisotitis mediainfectious diseasesbacteriology

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 9 , September 2025 , pp. 838 - 843
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

NW + SS devised the project and designed the study. NW, SM, AE collected and analysed the data for the project. NW wrote the manuscript with input from all authors. This work was presented at the European Society of Paediatric Otorhinolaryngology Annual 2023 meeting, 20–23 May, Liverpool, UK

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