Treatment Failure by Microorganism in Patients who did not Receive Antibiotics Prior to Specimen Collectiona
| Organism . | Organism Prevalence (N = 149) . | Treatment Success (N = 148) . | Treatment Failure (N = 8) . | OR (95% CI)b . | aOR (95% CI)b,c . | aOR (95% CI)b,d . |
|---|---|---|---|---|---|---|
| Microorganism types (n (%, row))a,e | ||||||
| No microorganism identified | 14 (9.4) | 13 (92.9) | 1 (7.1) | Referent | Referent | Referent |
| Any bacteria | 123 (82.6) | 117 (95.1) | 7 (5.6) | .67 (.07, 5.98) | .66 (.06, 7.43) | 1.05 (.10, 10.84) |
| Any virusf | 71 (47.6) | 68 (95.8) | 3 (4.2) | .58 (.06, 6.01) | .003 (3e-7, 28.71) | .52 (.04, 6.75) |
| Only bacteria | 64 (42.9) | 60 (92.3) | 4 (6.2) | .87 (.09, 8.40) | .68 (.05, 8.56) | 1.00 (.0.10, 10.69) |
| Only virus(es) | 12 (8.0) | 11 (91.7) | 1 (8.3) | 1.18 (.07, 21.17) | NCg | NC |
| Either bacteria or virus(es) | 135 (90.6) | 128 (94.8) | 7 (5.2) | .71 (.08, 6.24) | .57 (.05, 6.48) | 1.02 (.10, 10.52) |
| Both bacteria and virus(es) | 59 (39.6) | 57 (96.6) | 2 (3.4) | .46 (.04, 5.42) | .004 (3e-7, 42.46) | .51 (.03, 7.58) |
| Bacterial pathogens (n(%))h,i | ||||||
| No bacteria identifiedj | 26 (17.4) | 24 (92.3) | 2 (7.7) | Referent | Referent | Referent |
| S. pneumoniae | 51 (34.2) | 49 (96.1) | 2 (3.9) | .49 (.06, 3.69) | .43 (.03, 5.27) | .58 (.07, 4.83) |
| H. influenzae | 30 (20.1) | 29 (96.7) | 1 (3.3) | .41 (.04, 4.85) | .47 (.03, 8.48) | .63 (.04, 9.25) |
| No beta-lactamase productionk | 19 (63.3) | 18 (94.7) | 1 (5.3) | .67 (.056, 7.94) | .89 (.04, 18.48) | .87 (.06, 12.84) |
| Beta-lactamase productionk | 11 (36.7) | 11 (100.0) | 0 (0.0) | NC | NC | NC |
| M. catarrhalis | 78 (52.3) | 74 (94.9) | 4 (5.1) | .65 (.11, 3.77) | .41 (.03, 5.01) | 1.15 (.17, 7.65) |
| S. aureus | 21 (14.1) | 20 (95.2) | 1 (4.8) | .60 (.05, 7.11) | .68 (.02, 20.0) | .90 (.05, 14.75) |
| Beta-lactamase-producing bacteriall | 98 (65.8) | 93 (94.9) | 5 (5.1) | .65 (.12, 3.53) | .55 (.08, 4.07) | .98 (.16, 5.90) |
| Non-beta-lactamase-producing bacteria | 51 (34.2) | 48 (94.1) | 3 (5.9) | .50 (.04, 5.89) | .50 (.03, 9.7) | .41 (.03, 5.65) |
| Bacterial pathogens (n(%)) | ||||||
| No bacteria identified | 25 (16.8) | 24 (96.0) | 1 (4.0) | Referent | Referent | Referent |
| Only S. pneumoniae | 2 (1.3) | 2 (100.0) | 0 (0.0) | NC | NC | NC |
| Only H. influenzae | 9 (6.0) | 9 (100.0) | 0 (0.0) | NC | NC | NC |
| No beta-lactamase productionm | 5 (55.6) | 5 (100.0) | 0 (0.0) | NC | NC | NC |
| Beta-lactamase productionm | 4 (44.4) | 4 (100.0) | 0 (0.0) | NC | NC | NC |
| Only M. catarrahlis | 17 (1.4) | 15 (88.2) | 2 (11.8) | 1.6 (.20, 12.60) | NC | 21.13 (.18, 2397.91) |
| Only S. aureus | 5 (3.4) | 4 (80.0) | 1 (20.0) | 3.0 (.22, 41.35) | 3.80 (.06, 240.03) | 5.84 (.16, 219.18) |
| Organism . | Organism Prevalence (N = 149) . | Treatment Success (N = 148) . | Treatment Failure (N = 8) . | OR (95% CI)b . | aOR (95% CI)b,c . | aOR (95% CI)b,d . |
|---|---|---|---|---|---|---|
| Microorganism types (n (%, row))a,e | ||||||
| No microorganism identified | 14 (9.4) | 13 (92.9) | 1 (7.1) | Referent | Referent | Referent |
| Any bacteria | 123 (82.6) | 117 (95.1) | 7 (5.6) | .67 (.07, 5.98) | .66 (.06, 7.43) | 1.05 (.10, 10.84) |
| Any virusf | 71 (47.6) | 68 (95.8) | 3 (4.2) | .58 (.06, 6.01) | .003 (3e-7, 28.71) | .52 (.04, 6.75) |
| Only bacteria | 64 (42.9) | 60 (92.3) | 4 (6.2) | .87 (.09, 8.40) | .68 (.05, 8.56) | 1.00 (.0.10, 10.69) |
| Only virus(es) | 12 (8.0) | 11 (91.7) | 1 (8.3) | 1.18 (.07, 21.17) | NCg | NC |
| Either bacteria or virus(es) | 135 (90.6) | 128 (94.8) | 7 (5.2) | .71 (.08, 6.24) | .57 (.05, 6.48) | 1.02 (.10, 10.52) |
| Both bacteria and virus(es) | 59 (39.6) | 57 (96.6) | 2 (3.4) | .46 (.04, 5.42) | .004 (3e-7, 42.46) | .51 (.03, 7.58) |
| Bacterial pathogens (n(%))h,i | ||||||
| No bacteria identifiedj | 26 (17.4) | 24 (92.3) | 2 (7.7) | Referent | Referent | Referent |
| S. pneumoniae | 51 (34.2) | 49 (96.1) | 2 (3.9) | .49 (.06, 3.69) | .43 (.03, 5.27) | .58 (.07, 4.83) |
| H. influenzae | 30 (20.1) | 29 (96.7) | 1 (3.3) | .41 (.04, 4.85) | .47 (.03, 8.48) | .63 (.04, 9.25) |
| No beta-lactamase productionk | 19 (63.3) | 18 (94.7) | 1 (5.3) | .67 (.056, 7.94) | .89 (.04, 18.48) | .87 (.06, 12.84) |
| Beta-lactamase productionk | 11 (36.7) | 11 (100.0) | 0 (0.0) | NC | NC | NC |
| M. catarrhalis | 78 (52.3) | 74 (94.9) | 4 (5.1) | .65 (.11, 3.77) | .41 (.03, 5.01) | 1.15 (.17, 7.65) |
| S. aureus | 21 (14.1) | 20 (95.2) | 1 (4.8) | .60 (.05, 7.11) | .68 (.02, 20.0) | .90 (.05, 14.75) |
| Beta-lactamase-producing bacteriall | 98 (65.8) | 93 (94.9) | 5 (5.1) | .65 (.12, 3.53) | .55 (.08, 4.07) | .98 (.16, 5.90) |
| Non-beta-lactamase-producing bacteria | 51 (34.2) | 48 (94.1) | 3 (5.9) | .50 (.04, 5.89) | .50 (.03, 9.7) | .41 (.03, 5.65) |
| Bacterial pathogens (n(%)) | ||||||
| No bacteria identified | 25 (16.8) | 24 (96.0) | 1 (4.0) | Referent | Referent | Referent |
| Only S. pneumoniae | 2 (1.3) | 2 (100.0) | 0 (0.0) | NC | NC | NC |
| Only H. influenzae | 9 (6.0) | 9 (100.0) | 0 (0.0) | NC | NC | NC |
| No beta-lactamase productionm | 5 (55.6) | 5 (100.0) | 0 (0.0) | NC | NC | NC |
| Beta-lactamase productionm | 4 (44.4) | 4 (100.0) | 0 (0.0) | NC | NC | NC |
| Only M. catarrahlis | 17 (1.4) | 15 (88.2) | 2 (11.8) | 1.6 (.20, 12.60) | NC | 21.13 (.18, 2397.91) |
| Only S. aureus | 5 (3.4) | 4 (80.0) | 1 (20.0) | 3.0 (.22, 41.35) | 3.80 (.06, 240.03) | 5.84 (.16, 219.18) |
aCulture for bacteria, RVP for viruses (PCR); only bacterial pathogens recovered in culture reported in this table—see supplement for data from culture plus PCR.
bp-value less than 0.100 indicated by an asterisk (*).
cCovariates for logistic regression adjustment: age category, meets AAP criteria, co-infection with virus, and language (smoking status, sex, race, ethnicity, and pre- or peri-covid period were excluded due to collinearity). Additional covariates were included after confirming they were not colinear with the different organism categories: AOM-SOS scale at 5 and 14 days, laterality of infection, number of days antibiotic taken.
dCovariates for logistic regression adjustment: age category, meets AAP criteria, co-infection with virus, laterality of infection, and language (smoking status, sex, race, ethnicity, and pre- or peri-covid period were excluded due to collinearity).
eFor group “Organism types” referent used for odds ratio estimation is “No organisms.”
fIncludes patients positive for COVID-19.
gNC, Not calculable.
hThese categories include culture positive for specified bacteria, and viral PCR could be positive or negative. Reference is no bacteria.
iFive patients had positive cultures for other bacteria, which included diptheroids (1), few mixed oral flora (1), strep group A beta hemolytic (1), many mixed bacterial flora (1), type missing (1).
jOne patient had discrepant entries with data indicating organisms were present (cultureresult_1num = 0), but no individual organisms were identified in culture. Individual culture results were used to tally patients with no bacteria identified.
kIn patients with any H. influenzae, denominator of 30.
lIncludes all M. catarrhalis positive cultures, all S. aureus positive cultures, and all beta-lactamase-producing H. influenzae cultures.
mIn patients with only H. influenzae, denominator of 9.
Treatment Failure by Microorganism in Patients who did not Receive Antibiotics Prior to Specimen Collectiona
| Organism . | Organism Prevalence (N = 149) . | Treatment Success (N = 148) . | Treatment Failure (N = 8) . | OR (95% CI)b . | aOR (95% CI)b,c . | aOR (95% CI)b,d . |
|---|---|---|---|---|---|---|
| Microorganism types (n (%, row))a,e | ||||||
| No microorganism identified | 14 (9.4) | 13 (92.9) | 1 (7.1) | Referent | Referent | Referent |
| Any bacteria | 123 (82.6) | 117 (95.1) | 7 (5.6) | .67 (.07, 5.98) | .66 (.06, 7.43) | 1.05 (.10, 10.84) |
| Any virusf | 71 (47.6) | 68 (95.8) | 3 (4.2) | .58 (.06, 6.01) | .003 (3e-7, 28.71) | .52 (.04, 6.75) |
| Only bacteria | 64 (42.9) | 60 (92.3) | 4 (6.2) | .87 (.09, 8.40) | .68 (.05, 8.56) | 1.00 (.0.10, 10.69) |
| Only virus(es) | 12 (8.0) | 11 (91.7) | 1 (8.3) | 1.18 (.07, 21.17) | NCg | NC |
| Either bacteria or virus(es) | 135 (90.6) | 128 (94.8) | 7 (5.2) | .71 (.08, 6.24) | .57 (.05, 6.48) | 1.02 (.10, 10.52) |
| Both bacteria and virus(es) | 59 (39.6) | 57 (96.6) | 2 (3.4) | .46 (.04, 5.42) | .004 (3e-7, 42.46) | .51 (.03, 7.58) |
| Bacterial pathogens (n(%))h,i | ||||||
| No bacteria identifiedj | 26 (17.4) | 24 (92.3) | 2 (7.7) | Referent | Referent | Referent |
| S. pneumoniae | 51 (34.2) | 49 (96.1) | 2 (3.9) | .49 (.06, 3.69) | .43 (.03, 5.27) | .58 (.07, 4.83) |
| H. influenzae | 30 (20.1) | 29 (96.7) | 1 (3.3) | .41 (.04, 4.85) | .47 (.03, 8.48) | .63 (.04, 9.25) |
| No beta-lactamase productionk | 19 (63.3) | 18 (94.7) | 1 (5.3) | .67 (.056, 7.94) | .89 (.04, 18.48) | .87 (.06, 12.84) |
| Beta-lactamase productionk | 11 (36.7) | 11 (100.0) | 0 (0.0) | NC | NC | NC |
| M. catarrhalis | 78 (52.3) | 74 (94.9) | 4 (5.1) | .65 (.11, 3.77) | .41 (.03, 5.01) | 1.15 (.17, 7.65) |
| S. aureus | 21 (14.1) | 20 (95.2) | 1 (4.8) | .60 (.05, 7.11) | .68 (.02, 20.0) | .90 (.05, 14.75) |
| Beta-lactamase-producing bacteriall | 98 (65.8) | 93 (94.9) | 5 (5.1) | .65 (.12, 3.53) | .55 (.08, 4.07) | .98 (.16, 5.90) |
| Non-beta-lactamase-producing bacteria | 51 (34.2) | 48 (94.1) | 3 (5.9) | .50 (.04, 5.89) | .50 (.03, 9.7) | .41 (.03, 5.65) |
| Bacterial pathogens (n(%)) | ||||||
| No bacteria identified | 25 (16.8) | 24 (96.0) | 1 (4.0) | Referent | Referent | Referent |
| Only S. pneumoniae | 2 (1.3) | 2 (100.0) | 0 (0.0) | NC | NC | NC |
| Only H. influenzae | 9 (6.0) | 9 (100.0) | 0 (0.0) | NC | NC | NC |
| No beta-lactamase productionm | 5 (55.6) | 5 (100.0) | 0 (0.0) | NC | NC | NC |
| Beta-lactamase productionm | 4 (44.4) | 4 (100.0) | 0 (0.0) | NC | NC | NC |
| Only M. catarrahlis | 17 (1.4) | 15 (88.2) | 2 (11.8) | 1.6 (.20, 12.60) | NC | 21.13 (.18, 2397.91) |
| Only S. aureus | 5 (3.4) | 4 (80.0) | 1 (20.0) | 3.0 (.22, 41.35) | 3.80 (.06, 240.03) | 5.84 (.16, 219.18) |
| Organism . | Organism Prevalence (N = 149) . | Treatment Success (N = 148) . | Treatment Failure (N = 8) . | OR (95% CI)b . | aOR (95% CI)b,c . | aOR (95% CI)b,d . |
|---|---|---|---|---|---|---|
| Microorganism types (n (%, row))a,e | ||||||
| No microorganism identified | 14 (9.4) | 13 (92.9) | 1 (7.1) | Referent | Referent | Referent |
| Any bacteria | 123 (82.6) | 117 (95.1) | 7 (5.6) | .67 (.07, 5.98) | .66 (.06, 7.43) | 1.05 (.10, 10.84) |
| Any virusf | 71 (47.6) | 68 (95.8) | 3 (4.2) | .58 (.06, 6.01) | .003 (3e-7, 28.71) | .52 (.04, 6.75) |
| Only bacteria | 64 (42.9) | 60 (92.3) | 4 (6.2) | .87 (.09, 8.40) | .68 (.05, 8.56) | 1.00 (.0.10, 10.69) |
| Only virus(es) | 12 (8.0) | 11 (91.7) | 1 (8.3) | 1.18 (.07, 21.17) | NCg | NC |
| Either bacteria or virus(es) | 135 (90.6) | 128 (94.8) | 7 (5.2) | .71 (.08, 6.24) | .57 (.05, 6.48) | 1.02 (.10, 10.52) |
| Both bacteria and virus(es) | 59 (39.6) | 57 (96.6) | 2 (3.4) | .46 (.04, 5.42) | .004 (3e-7, 42.46) | .51 (.03, 7.58) |
| Bacterial pathogens (n(%))h,i | ||||||
| No bacteria identifiedj | 26 (17.4) | 24 (92.3) | 2 (7.7) | Referent | Referent | Referent |
| S. pneumoniae | 51 (34.2) | 49 (96.1) | 2 (3.9) | .49 (.06, 3.69) | .43 (.03, 5.27) | .58 (.07, 4.83) |
| H. influenzae | 30 (20.1) | 29 (96.7) | 1 (3.3) | .41 (.04, 4.85) | .47 (.03, 8.48) | .63 (.04, 9.25) |
| No beta-lactamase productionk | 19 (63.3) | 18 (94.7) | 1 (5.3) | .67 (.056, 7.94) | .89 (.04, 18.48) | .87 (.06, 12.84) |
| Beta-lactamase productionk | 11 (36.7) | 11 (100.0) | 0 (0.0) | NC | NC | NC |
| M. catarrhalis | 78 (52.3) | 74 (94.9) | 4 (5.1) | .65 (.11, 3.77) | .41 (.03, 5.01) | 1.15 (.17, 7.65) |
| S. aureus | 21 (14.1) | 20 (95.2) | 1 (4.8) | .60 (.05, 7.11) | .68 (.02, 20.0) | .90 (.05, 14.75) |
| Beta-lactamase-producing bacteriall | 98 (65.8) | 93 (94.9) | 5 (5.1) | .65 (.12, 3.53) | .55 (.08, 4.07) | .98 (.16, 5.90) |
| Non-beta-lactamase-producing bacteria | 51 (34.2) | 48 (94.1) | 3 (5.9) | .50 (.04, 5.89) | .50 (.03, 9.7) | .41 (.03, 5.65) |
| Bacterial pathogens (n(%)) | ||||||
| No bacteria identified | 25 (16.8) | 24 (96.0) | 1 (4.0) | Referent | Referent | Referent |
| Only S. pneumoniae | 2 (1.3) | 2 (100.0) | 0 (0.0) | NC | NC | NC |
| Only H. influenzae | 9 (6.0) | 9 (100.0) | 0 (0.0) | NC | NC | NC |
| No beta-lactamase productionm | 5 (55.6) | 5 (100.0) | 0 (0.0) | NC | NC | NC |
| Beta-lactamase productionm | 4 (44.4) | 4 (100.0) | 0 (0.0) | NC | NC | NC |
| Only M. catarrahlis | 17 (1.4) | 15 (88.2) | 2 (11.8) | 1.6 (.20, 12.60) | NC | 21.13 (.18, 2397.91) |
| Only S. aureus | 5 (3.4) | 4 (80.0) | 1 (20.0) | 3.0 (.22, 41.35) | 3.80 (.06, 240.03) | 5.84 (.16, 219.18) |
aCulture for bacteria, RVP for viruses (PCR); only bacterial pathogens recovered in culture reported in this table—see supplement for data from culture plus PCR.
bp-value less than 0.100 indicated by an asterisk (*).
cCovariates for logistic regression adjustment: age category, meets AAP criteria, co-infection with virus, and language (smoking status, sex, race, ethnicity, and pre- or peri-covid period were excluded due to collinearity). Additional covariates were included after confirming they were not colinear with the different organism categories: AOM-SOS scale at 5 and 14 days, laterality of infection, number of days antibiotic taken.
dCovariates for logistic regression adjustment: age category, meets AAP criteria, co-infection with virus, laterality of infection, and language (smoking status, sex, race, ethnicity, and pre- or peri-covid period were excluded due to collinearity).
eFor group “Organism types” referent used for odds ratio estimation is “No organisms.”
fIncludes patients positive for COVID-19.
gNC, Not calculable.
hThese categories include culture positive for specified bacteria, and viral PCR could be positive or negative. Reference is no bacteria.
iFive patients had positive cultures for other bacteria, which included diptheroids (1), few mixed oral flora (1), strep group A beta hemolytic (1), many mixed bacterial flora (1), type missing (1).
jOne patient had discrepant entries with data indicating organisms were present (cultureresult_1num = 0), but no individual organisms were identified in culture. Individual culture results were used to tally patients with no bacteria identified.
kIn patients with any H. influenzae, denominator of 30.
lIncludes all M. catarrhalis positive cultures, all S. aureus positive cultures, and all beta-lactamase-producing H. influenzae cultures.
mIn patients with only H. influenzae, denominator of 9.
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