الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Otitis media is an infectious condition of the ear that can appear with or without acute symptoms. It is a common disease of infants and children world wide. The causes of AOM are many and varied, and result from environmental variables such as supine feeding in young infants, early initiation into group day care, short duration of breast feeding and exposure to cigarette smoke. In addition anatomical factors may be attributable to the increased incidence of AOM in children. In most instances bacterial invasion of the middle ear is the cause of AOM in children. Surgery for otitis media with effusion (ventilating tubes in the tympanic membrane) is the most common surgical procedure carried out on children. Developmental and behavioral disorders have also been observed as a consequence of early onset of OME. Otitis media is thus an important public health problem because of the morbidity, social costs, and consequences with which it is associated. This work aimed at investigating acute otitis media in children, isolation and identification of responsible bacterial pathogens and their antibiotic sensitivity, besides the detection of ?-lactamase activity in the sample and for the isolated colonies. The present work included 100 children with acute otitis media who attended the outpatient clinics of El-Shatby University Hospital, Sharqu El-Madina Hospital and the Health Insurance clinics in Alexandria over the period from March to December 1998. Detailed history including personal history, complaint, present history, past history of similar or recurrent attacks & other associated diseases. Middle ear discharge was collected on sterile cotton swabs from the external ear canal, 2 swabs were taken for each child. One swab was enrolled on a clean glass slide for Gram staining, and then was used for direct detection of the presence of ?-lactamase activity using the nitrocefin sticks. The other swab was used for inculation on plates of blood agar, chocolate agar and Mac Conkey’s agar. The plates were incubated aerobically in a candle jar at 37?C for 24 - 48 hours. Isolates were fully identified by Gram stain and biochemical tests. ?-lactamase activity was tested for the isolated colonies. All isolates were subjected to antibiotic susceptibility testing. The following antibiotics were included: Penicillin G, Ampicillin, Amoxycillin, Cephalexin, Ceftazidime, cefaclor, Cephapirin, Cephradine, Enythromycin, Unasyn, Cefuroxime, Sulphamethoxazole / Trimethoprim, Amoxicillin / Clavulanate, Vancomycin, Methicillin. The results showed that: • Male children were more exposed to otitis media (61) than females (39).