Microbiology and antimicrobial resistance in pediatric acute rhinosinusitis with acute otitis media

Aim: This study aimed to describe organisms cultured from pediatric acute rhinosinusitis (ARS) with otitis media (OM), as well as current resistance patterns of pathogens. Material and Methods: The study was conducted from February to October 2022. Children with acute rhinosinusitis and acute otitis media underwent endoscopic-guided cultures at National Otorhinolaryngology Hospital of Vietnam to obtain pathogens and for analysis of antibiotic resistance. Results: The total of 72 cultures were obtained from 72 children with acute rhinosinusitis and otitis media under the age of 6 years. Gram-negative bacteria were isolated in 48.6% and Gram-positive bacteria in 37.5% of patients. Susceptibility rates of H. influenzae were 100.0% to meropenem and piperacillin/ tazobactam; 55.6% to amoxicillin/ clavulanic acid. Resistance rates of H. influenzae were 100.0% to both cefuroxime and co-trimoxazole. Susceptibility rates of S. pneumoniae were 100.0% to levofloxacin, moxifloxacin, vancomycin, tigecycline, rifampicin and linezolid. Resistance rates of S. pneumoniae were 100.0% to erythromycin, 93.3% to tetracycline and 86.7 to clindamycin. Susceptibility rates of M. catarrhalis were 100.0% to meropenem, ceftazidime, ciprofloxacin, levofloxacin, gentamycin and doxycycline. Resistance rates of M. catarrhalis were 100.0% to co-trimoxazole, 87.5% to azithromycin. Discussion: This study highlights that H influenzae, S. pneumoniae, M. catarrhalis, and S. aureus are the major bacteria found in pediatric acute rhinosinusitis with acute otitis media. Because of different patterns of antibiotic resistance, a targeted antibiotic treatment according to culture sensitivity studies is needed for more effective therapy.