Impact of resistant pneumococcus on rates of acute mastoiditis

Abstract

OBJECTIVE To determine whether the rate of acute mastoiditis is rising, specifically as a result of antibiotic-resistant strains of Streptococcus pneumoniae. METHODS A retrospective chart review of all patients with a discharge diagnosis of acute mastoiditis between July 1, 1987, and June 30, 1997, was performed at our academic, tertiary-care medical center. There were no interventions, and the main outcome measures included the number of cases of acute or coalescent mastoiditis, stratified by pathogen, per year. RESULTS The rate of acute mastoiditis as a proportion of yearly otorhinolaryngology admissions increased linearly over time ( P = 0.024). Pneumococcal-related rates of acute mastoiditis, expressed as a proportion of yearly hospital and otorhinolaryngology admissions, increased linearly over time ( P = 0.002, P = 0.002). All but 1 case of pneumococcal mastoiditis during the past 3 years were caused by penicillin-resistant strains. CONCLUSIONS The emergence of antibiotic-resistant S pneumoniae may be responsible for an increasing rate of acute mastoiditis.