Rhinosinusitis in Children

Rhinosinusitis is the inflammation of the mucous membranes of nose and paranasal sinus(es). 5–13% of upper respiratory tract infections in children complicate into acute rhinosinusitis. Though not life threatening, it profoundly affects child’s school performance and sleep pattern. If untreated, it could progress to chronic rhinosinusitis (CRS). The pathogens involved in perpetuation of CRS consist of multidrug-resistant mixed microflora. CRS is challenging to manage and could further extend to cause eye or intracranial complications. In children, CRS diagnosis is often either missed or incomprehensive. Due to this, morbidity and strain on healthcare budget are tremendous. Flexible fiberoptic endoscopy has revolutionized management of CRS. Its utility in children is being increasingly recognized. Optimal management entails specific appropriate antimicrobials as well as treatment of underlying causes. The aim is to normalize sinus anatomy and physiology and regain normal mucociliary function and clearance.

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Serotypes and Antibiotic Resistance of Streptococcus pneumoniae from Adenoids in Preschool Children with Recurrent Upper Respiratory Tract Infection

Polish Journal of Microbiology ◽

10.33073/pjm-2013-053 ◽

2013 ◽

Vol 62 (4) ◽

pp. 385-390 ◽

Cited By ~ 2

Author(s):

IZABELA KORONA-GLOWNIAK ◽

ARTUR NIEDZIELSKI ◽

ANNA MALM ◽

GRAŻYNA NIEDZIELSKA

Keyword(s):

Antibiotic Resistance ◽

Respiratory Tract ◽

Vaccine Coverage ◽

Multidrug Resistant ◽

Upper Respiratory Tract ◽

Persistent Symptoms ◽

Adenoid Tissue ◽

Immunization Programme ◽

Upper Respiratory ◽

Tract Infections

We investigated children aged 2-5, who had gone adenoidectomy for recurrent and/or persistent symptoms of upper respiratory tract infections for prevalence of pneumococci in adenoid tissue. Serotypes and antibiotic resistance patterns of the isolated pneumococci were determined and also risk factors of pneumococcal colonization were defined. S. pneumoniae colonization in adenoids was found in 62 (60.2%) children. Serotypes belonged to 10-valent and 13-valent pneumococcal conjugated vaccines (PCVs) constituted 56.1% and 68.2% of the isolates, respectively. Decreased susceptibility to penicillin was found in 45.5% of isolates; pneumococci were resistant to cotrimoxazole (62.1%), tetracycline (43.9%), erythromycin (54.5%), clindamycin (54.5%) and chloramphenicol (31.8%). Multidrug resistant S. pneumoniae comprised 57.6% of the isolates. Antibiotic resistant pneumococci were mostly distributed among serotypes belonged to 10-valent and 13-valent PCVs. Good vaccine coverage among the isolated pneumococci confirmed that the introduction of PCVs in the national immunization programme may reduce the pool of resistant and multidrug resistant pneumococci in a community.

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Multidrug-Resistant Streptococcus pneumoniae in Poland: Identification of Emerging Clones

Journal of Clinical Microbiology ◽

10.1128/jcm.37.6.1739-1745.1999 ◽

1999 ◽

Vol 37 (6) ◽

pp. 1739-1745 ◽

Cited By ~ 25

Author(s):

Karin Overweg ◽

Peter W. M. Hermans ◽

Krzysztof Trzcinski ◽

Marcel Sluijter ◽

Ronald de Groot ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Respiratory Tract Infections ◽

Multidrug Resistant ◽

Upper Respiratory Tract ◽

Epidemiological Analysis ◽

Medical Centers ◽

Genetic Clusters ◽

Clonal Origin ◽

Upper Respiratory ◽

Tract Infections

Penicillin resistance among Streptococcus pneumoniaeisolates has rapidly emerged in Poland during the last decade and has reached prevalence levels of up to 14.4% in 1997. In order to investigate the nature of this increase, a molecular epidemiological analysis of non-penicillin-susceptible multidrug-resistant pneumococci isolated in 1995 and 1996 was conducted. Thirty-seven patients who suffered mainly from upper respiratory tract infections and pneumococcal pneumonia were enrolled in this study. The medical centers to which the patients were admitted were located in 16 Polish towns across the country. Eight distinct BOX PCR types were observed, representing 14 subtypes. Restriction fragment end labeling (RFEL) analysis divided the pneumococcal strains into 16 distinct types. By combining the BOX PCR and RFEL data, four genetically distinct clusters of strains were identified. Two clusters represented the genetic clones 23F and 9V, which have recently emerged all over the world. The two other genetic clusters, which represented serotypes 23F and 6B, clearly predominated in the analyzed collection of Polish non-penicillin-susceptible pneumococcal strains. Since the latter clusters did not match any of the 133 RFEL types of non-penicillin-susceptible pneumococci collected in 15 other countries, their Polish clonal origin is most likely.

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