Antimicrobial Resistance: Middle Ear Study Involving Saskatchewan Native and Non-Native Children
Middle ear infections (MEI) are a significant cause of morbidity among children, particularly for those who are Native and living in northern geographic regions of Canada. The widespread use of antimicrobial agents and the dramatic rise in the number of antibiotic-resistant pathogens encountered within Saskatchewan, create concern as to whether significant differences exist between Native and Non-Native children in regards to the percentage of middle ear pathogens resistant to antimicrobial agents. The recognition that various communities may serve as reservoirs of antibiotic-resistant bacteria, has raised interest in studying the transmission of these bacteria. In order to clearly assess the prevalence of antibiotic resistance in terms of ethnicity and location, 285 middle ear aspirates were collected from Native and Non-Native children: 98 bacterial pathogens were recovered from 54 culture-positive individuals (68 % Non-Native, 32 % Native). Pulsed field gel electrophoresis (PFGE) and demographic data acquisition were methods used for studying the epidemiology of resistance. Resistance to ampicillin was found in 20 % and 100 % of Haemophilus influenzae and Moraxella caiarrhalis isolates, respectively. Penicillin-resistant Streptococcus pneumoniae was found in 13 % of the isolates. Overall, Non-Native children seemed to harbor antimicrobial resistant pathogens more frequently, (77 %; p=0.001), specifically in regards to the number of ampicillin-resistant H. influenzae isolates (38 %; p< 0.005). Geographical trends in resistance were seen among children of race, however, limited demographic features could be ascribed to the risk of clonal spread of resistant pathogens. Recovery of antimicrobial resistant pathogens from children suffering from MEl continues to be prevalent. Differences in resistance rates were seen among children of different ethnic backgrounds and who were living in various geographical communities in Saskatchewan. Further study is necessary to conclusively establish whether the differences are a true representation of antimicrobial susceptibility for MEI or due to limited sample collection.