Abstracts / International Journal of Infectious Diseases 73S (2018) 3–398
Conclusion: The obtained data allow to recommend correction
of local cytokine profile with ADFNɑ and consider it inclusion in
scheme of supportive treatment of AD in adults.
https://doi.org/10.1016/j.ijid.2018.04.3777
UMP. 144
Investigation of biofilm formation in adenoids
and middle ear in children with chronic otitis
media
A. Farinati 1,∗ , A. Garcia Segui 2 , A. Fernandez
Nuñez 2 , E. Mansilla 3
1 Facultad de Medicina, Universidad del Salvador,
Catedra Microbiologia, Buenos Aires, Argentina
2 USAL, Microbiology, CABA, Argentina
3 UBA, Othorinolaringology Department, CABA,
Argentina
Background: Presence of biofilm (BF) chronic otitis media
(COM) has been demonstrated in experimental studies of chin-
chillas and also of tympanostomy tubes in children with refractory
otorrhea postimpanostomy. To investigate the presence of BF in
the middle ear (ME) of children with COM to which tympanostomy
tubes were to be placed
Methods & Materials: We studied 19 children with OME who
were treated with tympanostomy tubes. During the surgical pro-
cedure, the material of the middle ear was aspirated, extended on
glass devices (GD) and immediately placed in a culture medium for
the study of BF. The adenoids were sent to the laboratory where
cuts were made to make imprints, and then proceeded similarly to
the otical material. GD were incubated at 36 ◦ C for 24 hours. Subse-
quently an aliquot of each broth, where the devices were incubated,
was taken, inoculated into two chocolate agar plates and incubated
for 24 hours (planktonic bacteria evaluation). The GD were studied
according to the usual technique for BF.coincidence.
Results: Mixed BF were obtained in 16 ME samples and in
18 AD samples (100%). The predominant microorganisms (MOs)
were viridans group Streptococcus, Streptococcus pneumoniae,
Haemophilus influenzae, Neisseria spp and coagulase negative
Staphylococcus.
Total concordance of BF from ME with BF from AD was observed
in 4 of the studied cases, partial in 9 cases and in the 3 remaining
cases of simultaneous study there was no coincidence.
Conclusion: Acute infections of the middle ear are usually
monomicrobial in their etiology (Haemophilus influenzae, Strepto-
coccus pneumoniae or Staphylococcus aureus). Our observations
of mixed BF in COM would indicate an ascent from the oropharyn-
geal microbiota. Its presence possibly facilitates the permanence of
the habitual pathogens by forming coaggregates and giving rise to
the mixed BF. The nature of the BF and the formation of exuberant
exopolymer difficults the arrival of antimicrobials to the interior,
allowing the persistence of the MOs and the recurrence of episodes
of otitis when MOs are released from the BF.
https://doi.org/10.1016/j.ijid.2018.04.3778
161
UMP. 145
Arguing against empiric treatment of urinary
tract infection in a Ghanaian tertiary care
hospital setting
B. Nuertey 1,∗ , A. Salifu 2 , J. Addai 3
1 Tamale Teaching Hospital, Public Health, Tamale,
Ghana
2 Tamale Teaching Hospital, Microbiology, Tamale,
Ghana
3 Korle-Bu Teaching Hospital, Accra, Ghana
Background: The diagnosis and treatment of urinary tract infec-
tion (UTI) in low and middle-income countries are mostly by
presumptive diagnosis and empiric treatment. We present data
from a one-year UTI surveillance programme, to argue against
empiric treatment of UTI, in a Ghanaian tertiary care hospital set-
ting.
Methods & Materials: Midstream urine samples of clinically
diagnosed UTI were collected. Microscopy, bacteria cultures and
antibiotic susceptibility tests were performed using standard pro-
cedures.
Results: Of the 1640 participants, 11.1% (n = 160), 22.3%
(n = 323), and 66.6% (n = 964) were respectively ≤18 years, 19–59
years, and >59 years old. One in four (25.8%, n = 423/1640) clinically
diagnosed UTI were positive for uropathogenic organisms. The top
five isolates were Escherichia coli (32.2%), Klebsiella species (20.3%),
Citrobacter species (9.2%), Pseudomonas species (8.8%) and Enter-
obacter species (7.3%). Pyuria at cut-off limits of 5 and 10 white
blood cell per high power field was associated with low sensitivity
(16.3% and 10.1% respectively) and high specificity (96.3% and 98.8%
respectively). None of the reported antibiotics, except amikacin
(84.6%) and gentamicin (62.5%), was effective against >50% of the
total UTI pathogens. Overall, 71.2% of the total UTI pathogens were
resistant to ciprofloxacin. Also, 67.6%, 66.7% and 89.3% of all UTI
pathogens were respectively resistant to Amoxicillin–clavulanic
acid, nitrofurantoin and trimethoprim/sulfamethazole.
Conclusion: The majority of clinically diagnosed UTI were cul-
ture negative for uropathogens. The uropathogens were associated
with high levels of resistance to several of the recommended
empiric antibiotics. The data show that UTI cannot be effectively
managed without regard for culture and drug susceptibility tests.
https://doi.org/10.1016/j.ijid.2018.04.3779