Methicillin-resistant Staphylococcus aureus colonization in otitis-prone children.

OBJECTIVES: To examine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among children undergoing bilateral myringotomy and tube insertion with or without adenoidectomy for chronic otitis media with effusion or recurrent acute otitis media, as well as to examine the occurrence of postoperative otorrhea in children who have vs do not have MRSA colonization.

DESIGN: Prospective cohort study.

SETTING: Hospital-based pediatric otolaryngology practice in a metropolitan area.

PATIENTS: Seventy-six children (51 boys and 25 girls), with a mean (SD) age of 3.6 (1.8) years.

INTERVENTIONS: Cultures for S aureus from the nasopharynx, external auditory canals, middle ears, and adenoid were obtained at the time of surgery, as well as middle ear cultures for bacteriologic culture and sensitivity. Patients were followed up for the development of otorrhea.

MAIN OUTCOME MEASURES: Prevalence of MRSA colonization and predictors of subsequent otorrhea.

RESULTS: The prevalence of S aureus colonization at the time of bilateral myringotomy and tube insertion was 7.9% (95% CI, 3.0%-16.4%), and the prevalence of MRSA colonization was 3.9% (95% CI, 0.8%-11.1%). All MRSA-positive specimens were resistant to erythromycin, and 2 were resistant to clindamycin. The mean (SD) follow-up period was 11.6 (3.6) months. Twenty-seven patients (35.5% [95% CI, 25.1%-46.9%]) developed at least 1 episode of otorrhea. One of 3 patients with MRSA colonization had subsequent otorrhea. The only predictor of otorrhea was younger age.

CONCLUSIONS: The prevalence of MRSA colonization among otitis-prone children was similar to rates reported among the general pediatric community. Methicillin-resistant S aureus colonization at the time of bilateral myringotomy and tube insertion was not predictive of subsequent otorrhea.