Antibiotic Resistance and URIs

Antibiotic Resistance and URIs

• Antibiotic resistance in bacteria is significantly driven by improper antibiotic prescriptions for urinary tract infections (URIs).
• Four primary types of URIs include:
  • Acute otitis media
  • Acute rhinosinusitis
  • Acute pharyngitis
  • Acute laryngitis

Acute Otitis Media (AOM)

• Acute otitis media (AOM) is characterized by the inflammation of the middle ear.
• Other forms of otitis media include:
  • Otitis Media with Effusion (OME):
    • Known as “glue ear”
    • Associated with hearing impairment and otorrhea (ear discharge) without inflammation of the tympanic membrane.
  • Chronic Otitis Media (COM):
    • Involves long-term inflammation of the middle ear.
    • Often caused by multidrug-resistant infections, leading to significant ear damage.

Global Impact of Otitis Media

• Otitis media affects approximately 700 million individuals globally each year.
• Children constitute around 50% of the cases reported.

Antibiotic Resistance and URIs

• Antibiotic resistance in bacteria is significantly driven by improper antibiotic prescriptions for urinary tract infections (URIs).
• Four primary types of URIs include:
  • Acute otitis media
  • Acute rhinosinusitis
  • Acute pharyngitis
  • Acute laryngitis

Acute Otitis Media (AOM)

• Acute otitis media (AOM) is characterized by the inflammation of the middle ear.
• Other forms of otitis media include:
  • Otitis Media with Effusion (OME):
    • Known as “glue ear”
    • Associated with hearing impairment and otorrhea (ear discharge) without inflammation of the tympanic membrane.
  • Chronic Otitis Media (COM):
    • Involves long-term inflammation of the middle ear.
    • Often caused by multidrug-resistant infections, leading to significant ear damage.

Global Impact of Otitis Media

• Otitis media affects approximately 700 million individuals globally each year.
• Children constitute around 50% of the cases reported.

Antibiotic Resistance and URIs

• Antibiotic resistance in bacteria is significantly driven by improper antibiotic prescriptions for urinary tract infections (URIs).
• Four primary types of URIs include:
  • Acute otitis media
  • Acute rhinosinusitis
  • Acute pharyngitis
  • Acute laryngitis

Acute Otitis Media (AOM)

• Acute otitis media (AOM) is characterized by the inflammation of the middle ear.
• Other forms of otitis media include:
  • Otitis Media with Effusion (OME):
    • Known as “glue ear”
    • Associated with hearing impairment and otorrhea (ear discharge) without inflammation of the tympanic membrane.
  • Chronic Otitis Media (COM):
    • Involves long-term inflammation of the middle ear.
    • Often caused by multidrug-resistant infections, leading to significant ear damage.

Global Impact of Otitis Media

• Otitis media affects approximately 700 million individuals globally each year.
• Children constitute around 50% of the cases reported.

Otitis Media Overview

• Otitis media refers to inflammation of the middle ear, with terminology derived from Latin: ‘oto’ (ear), ‘itis’ (inflammation), and ‘media’ (middle).

Types of Otitis Media

• Acute Otitis Media (AOM):

  • Sudden onset of middle ear infection, often accompanied by pain and fever.

• Otitis Media with Effusion (OME):

  • Commonly known as “glue ear”.
  • Characterized by fluid build-up in the middle ear without infection of the tympanic membrane.
  • Symptoms may include hearing impairment and otorrhea (ear discharge).

• Chronic Otitis Media (COM):

  • Long-term inflammation of the middle ear, leading to persistent issues.
  • Often results from multidrug-resistant infections, causing significant damage to ear structures.

Global Prevalence

• Over 700 million cases of otitis media occur worldwide annually.
• Approximately 50% of otitis media cases are found in children, highlighting its prevalence in pediatric populations.

Bacterial Resistance

• Most Haemophilus influenzae isolates produce β-lactamases, making them resistant to many β-lactam antibiotics.
• Nearly all Moraxella catarrhalis isolates in upper respiratory infections (URI) also produce β-lactamases.
• Over 50% of Streptococcus pneumoniae serotypes demonstrate resistance to penicillin.

Incidence of Bacterial Infections

• Bacterial infections account for approximately 70% of acute otitis media (AOM) cases per year when standard microbiological testing is conducted.

Clinical Presentation of AOM

• Acute otitis media cases frequently occur following viral upper respiratory infections.
• Nonverbal children experiencing ear pain often exhibit behaviors such as holding, rubbing, or tugging at their ear.
• Infants with AOM may cry more than usual, show irritability, and have trouble sleeping.

Common Pathogens in AOM

• Streptococcus pneumoniae is a significant cause of AOM.
• Non-typeable Haemophilus influenzae (NTHI) is another common causative agent.
• Moraxella catarrhalis is also frequently involved in cases of AOM.

Signs and Symptoms of Acute Otitis Media (AOM)

• Bulging of the tympanic membrane indicates increased pressure and fluid in the middle ear.
• Otorrhea refers to ear discharge or drainage, often occurring with AOM.
• Otoscopic examination is used to determine the presence and severity of AOM.
• Otalgia, or earache, is significant if pain is moderate to severe, especially if lasting 48 hours or more.
• Fever is noted in AOM cases; a severe fever is classified as a temperature of 39°C (102.2°F) or higher.

Bacterial Resistance in AOM

• Common bacterial pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
• These bacteria may exhibit resistance to β-lactam antibiotics due to the production of beta-lactamase enzymes or alterations in penicillin-binding proteins (PBPs).

Treatment Considerations

• Tympanocentesis, a procedure to drain fluid from the middle ear, may be considered after treatment failures or in cases of persistent AOM, providing relief and aiding in diagnosis.

Overview of Rhinosinusitis

• Rhinosinusitis, also known as sinusitis, involves inflammation of the sinuses and nasal cavity mucosa.
• Two main types:
  • Acute Viral Rhinosinusitis (AVR)
  • Acute Bacterial Rhinosinusitis (ABR)

Causes and Susceptibility

• Majority of rhinosinusitis cases are viral infections, commonly associated with the "common cold" (rhinovirus).
• All age groups are vulnerable to acute rhinosinusitis (AR).
• AR often appears seasonally, influenced by environmental factors.

Risk Factors

• Increased risk observed in specific demographics:
  • Children
  • Caregivers
  • Asthmatics

Symptoms of Rhinosinusitis

• Characterized by purulent (pus) nasal discharge.
• Common symptoms include:
  • Nasal obstruction or congestion
  • Facial pain and pressure
  • Headaches and dental pain
  • Fever
  • Ear pain
  • Halitosis (bad breath)

Diagnostic Criteria

• Persistent symptoms lasting more than 10 days indicate potential chronic infection.
• Severe or worsening symptoms, such as persistent fever, after 10 days may denote bacterial infection.
• "Double sickening" refers to initial improvement followed by a subsequent worsening of symptoms.

This quiz explores the critical issue of antibiotic resistance, particularly in relation to urinary tract infections (URIs). It covers various types of URIs, their impact on public health, and the specific case of acute otitis media. Understand the implications of antibiotic misuse and its global consequences.