Bacterial Spectrum of Spontaneously Ruptured Otitis Media in the Era of Pneumococcal Conjugate Vaccination in Germany

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2014 Aug 30

PMID 25169065

Citations 14

Authors

Mark van der Linden

Matthias Imohl

Andreas Busse

Markus Rose

Dieter Adam

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Otitis media is a common pediatric disease and the main reason for antibiotic prescription in children. Before implementation of routine childhood pneumococcal vaccination in Germany, serotypes contained in the seven-valent pneumococcal conjugate vaccine (PCV) were among the most frequent pneumococcal serotypes responsible for acute otitis media (AOM). This report describes the first 3 years of a prospective, multicenter, epidemiological cross-sectional study examining the bacteriology of middle ear fluids (MEF) and nasopharyngeal swabs (NPS) of children 2 months to 5 years of age with spontaneously perforated AOM in the era of routine pneumococcal vaccination. MEF was obtained from 963 subjects; NPS from 877. Reported case numbers steeply decreased over the three study years even though the recruiting base remained the same. Among subjects with relevant bacterial growth in their MEF swabs, 113 (11.7%) had Streptococcus pyogenes, 97 (10.1%) Staphylococcus aureus, 88 (9.1%) Streptococcus pneumoniae, 63 (6.5%) Haemophilus influenzae, and 8 (0.8%) Moraxella catarrhalis. S. pneumoniae isolates decreased from 41 (9.3%) in year 1 to 12 (5.7%) in year 3 (p = 0.128). PCV7 serotypes accounted for only 7.9% (n = 7) of isolated pneumococci. Of the 877 subjects with NPS cultures, 465 (53.0%) carried S. pneumoniae, 314 (35.8%) H. influenzae, 292 (33.3%) M. catarrhalis, and 110 (12.5%) S. pyogenes; 79.4% (n = 765) of the children were vaccinated with at least one dose of PCV. Carriage of pneumococci was slightly lower in vaccinated (47.8%) than in unvaccinated (52.7%) children (p = 0.254). PCV7 serotypes were carried by 9.6% of unvaccinated children but by only 4.2% of vaccinated children, resulting in a 56.3% vaccine effectiveness.

Conclusions: Following universal PCV7 immunization, a clear epidemiological impact of pneumococcal conjugate vaccination was observed as PCV7 serotypes have almost disappeared among AOM.

Citing Articles

Incidence of pneumococcal disease in children in Germany, 2014-2019: a retrospective cohort study.

Weaver J, Hu T, Podmore B, Barnett R, Obermuller D, Galetzka W BMC Pediatr. 2024; 24(1):755.

PMID: 39567949 PMC: 11577647. DOI: 10.1186/s12887-024-05003-7.

Clinical and economic burden of pneumococcal disease among individuals aged 16 years and older in Germany.

Deb A, Podmore B, Barnett R, Beier D, Galetzka W, Qizilbash N Epidemiol Infect. 2022; 150:e204.

PMID: 36345842 PMC: 9987016. DOI: 10.1017/S0950268822001182.

Incidence of acute otitis media in children < 16 years old in Germany during 2014-2019.

Hu T, Podmore B, Barnett R, Beier D, Galetzka W, Qizilbash N BMC Pediatr. 2022; 22(1):204.

PMID: 35418046 PMC: 9006409. DOI: 10.1186/s12887-022-03270-w.

Bacterial Spectrum of Spontaneously Ruptured Otitis Media in a 7-Year, Longitudinal, Multicenter, Epidemiological Cross-Sectional Study in Germany.

Imohl M, Perniciaro S, Busse A, van der Linden M Front Med (Lausanne). 2021; 8:675225.

PMID: 34095179 PMC: 8172772. DOI: 10.3389/fmed.2021.675225.

A longitudinal hospital-based epidemiology study to assess acute otitis media incidence and nasopharyngeal carriage in Korean children up to 24 months.

Lee J, Kim K, Jo D, Ma S, Kim J, Kim C Hum Vaccin Immunother. 2020; 16(12):3090-3097.

PMID: 32330397 PMC: 8641589. DOI: 10.1080/21645515.2020.1748978.

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