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Volume 18, Number 11—November 2012

CME ACTIVITY

Nasopharyngeal Bacterial Interactions in Children

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions (with a minimum 70% passing score) and earn continuing medical education (CME) credit, please go to www.medscape.org/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.org. If you are not registered on Medscape.org, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit may be acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questions online, print the certificate and present it to your national medical association for review.

Article Title: Nasopharyngeal Bacterial Interactions in Children

CME Questions

1. Based on the observational study by Dr. Xu and colleagues, which of the following statements about patterns of nasopharyngeal bacterial colonization and interaction in healthy young children is most likely correct?

A. Streptococcus pneumoniae is positively associated with Staphylococcus aureus

B. S. pneumoniae is positively associated with Moraxella catarrhalis

C. M. catarrhalis is positively associated with S. aureus

D. Patterns of nasopharyngeal bacterial colonization and interaction in health are likely to predict those at onset of acute otitis media (AOM)

2. Your patient is a 1-year-old, PCV7-vaccinated male with AOM. Based on the observational study by Dr. Xu and colleagues, which of the following statements about the role of Haemophilus influenzae is most likely correct?

A. The nasopharyngeal environment is likely to be unfavorable to H. influenzae colonization

B. At AOM onset, H. influenzae is positively associated with S. pneumoniae

C. At AOM onset, H. influenzae is positively associated with M. catarrhalis

D. H. influenzae may become a more important cause of AOM in pneumococcal conjugate vaccinated children

3. Based on the observational study by Dr. Xu and colleagues, which of the following statements about the role of other bacteria in AOM affecting the patient described in question 2 would most likely be correct?

A. During AOM, S. pneumoniae colonization is negatively associated with S. aureus

B. Viral-bacterial-host interactions in the nasopharynx during AOM are completely characterized

C. Findings of this study support the role of S. aureus as a frequent pathogen of AOM

D. Elimination of S. pneumoniae PCV7 strains has resulted in the remaining strains competing less effectively with H. influenzae in the nasopharynx and as a cause of AOM infection

Activity Evaluation

1. The activity supported the learning objectives.

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2. The material was organized clearly for learning to occur.

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3. The content learned from this activity will impact my practice.

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4. The activity was presented objectively and free of commercial bias.

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