ABSTRACT
To avoid the influence of pre-analytical steps, this study was performed using sterile blood spiked with defined loads of microorganisms as inoculum. Time-to-Detection (TTD) was evaluated for the most frequently encountered bacteria comparing two commercially available blood culture systems, BD BACTEC 9240 (Becton Dickinson) and BacT/ALERT (Organon Teknika). The effect of the most widely used antibiotics on TTD was evaluated on both systems. TTD was measured with antibiotics at their trough and at increasing concentrations. The results show that the BACTEC PLUS system recovers more pathogens with shorter time to detection than the BacT/ALERT FAN system when beta-lactam antibiotics (Ampicillin, Cefotaxime) are present at their respective trough concentration corresponding to parenteral therapy. The two systems seem to be equally efficient when Gentamicin, Ciprofloxacin and Trimethoprim/sulfamethoxazole are used; in the case of Vancomycin, BACTEC seems more effective than BacT/ALERT.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteremia/diagnosis , Bacteria/drug effects , Bacteria/isolation & purification , Blood/microbiology , Ampicillin/pharmacology , Anti-Bacterial Agents/metabolism , Bacteremia/microbiology , Bacteria/growth & development , Bacteriological Techniques/methods , Cefotaxime/pharmacology , Ciprofloxacin/pharmacology , Culture Media/chemistry , Enterococcus faecalis/drug effects , Enterococcus faecalis/growth & development , Enterococcus faecalis/isolation & purification , Escherichia coli/drug effects , Escherichia coli/growth & development , Escherichia coli/isolation & purification , Gentamicins/pharmacology , Staphylococcus aureus/drug effects , Staphylococcus aureus/growth & development , Staphylococcus aureus/isolation & purification , Streptococcus pneumoniae/drug effects , Streptococcus pneumoniae/growth & development , Streptococcus pneumoniae/isolation & purification , Time Factors , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacology , Vancomycin/pharmacologyABSTRACT
Acute otitis media (AOM) is one of the most common pediatric diseases; almost all children experience at least one episode, and a third have two or more episodes in the first three years of life. The disease burden of AOM has important medical, social and economic effects. AOM requires considerable financial assistance due to needing at least one doctor visit and a prescription for antipyretics and/or antibiotics. AOM is also associated with high indirect costs, which are mostly related to lost days of work for one parent. Moreover, due to its acute symptoms and frequent recurrences, AOM considerably impacts both the child and family's quality of life. AOM prevention, particularly recurrent AOM (rAOM), is a primary goal of pediatric practice. In this paper, we review current evidence regarding the efficacy of medical treatments and vaccines for preventing rAOM and suggest the best approaches for AOM-prone children.