Epidemiology and antimicrobial resistance of pathogens in pediatric sinus infections: a retrospective study at a Japanese otolaryngology clinic (2023-2025)
Abstract
Introduction: Haemophilus influenzae and Streptococcus pneumoniae are two of the major pathogens responsible for pediatric rhinosinusitis. Rising antimicrobial resistance (AMR) and pneumococcal serotype replacement have complicated treatment decisions. This study aimed to investigate bacterial distribution and AMR patterns in nasal discharge samples from children at a Japanese otolaryngology clinic.
Methods: We conducted a retrospective study at an otolaryngology clinic in Sendai, Japan, from February 2023 to March 2025. A total of 2009 nasal discharge specimens were analyzed. Bacterial identification and antimicrobial susceptibility testing were performed according to Clinical and Laboratory Standards Institute guidelines. H. influenzae and S. pneumoniae were phenotypically classified and stratified by age (0-2, 3-5, and 6-13 years). Age-group comparisons were performed using Fisher's exact test with Holm correction.
Results: Pathogens were detected in 1862 samples (92.7%). The most frequently isolated organisms were Moraxella catarrhalis (30.9%), H. influenzae (23.0%), and S. pneumoniae (20.6%). Among the 697 H. influenzae isolates, 44.8% were ampicillin-resistant, and 31.3% of all isolates were β-lactamase-negative ampicillin-resistant (BLNAR) strains. Some BLNAR strains exhibited reduced susceptibility to amoxicillin-clavulanic acid (MIC90 = 8 μg/mL). Cefotaxime, cefditoren, and levofloxacin remained highly active. Among the 625 S. pneumoniae isolates, 66.6% were…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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