Characteristics and Outcomes OF Acute Otitis Media in Children Carrying Streptococcus Pneumoniae or Haemophilus Influenzae in Their Nasopharynx as a Single Otopathogen After Introduction of the Heptavalent Pneumococcal Conjugate Vaccine

Abstract

After PCV7 implementation, clinical characteristics were investigated in 832 young children with acute otitis media, carrying a single S. pneumoniae or H. influenzae in their nasopharynx. As compared with H. influenzae, S. pneumoniae-associated acute otitis media was less frequently associated with treatment failure (odds ratio = 0.5; 95% confidence interval: 0.36-0.83) and recurrence (odds ratio = 0.4; 95% confidence interval: 0.22-0.75). Post-PCV7 serotype replacement seemed not to affect the acute otitis media characteristics in these children.

The multifaceted impact of pneumococcal conjugate vaccine implementation in children in France between 2001 to 2014

“…Probably because of the role of biofilm, AOM treatment failure due to H. influenzae was generally not related to antibiotic resistance. 28,37 By contrast, for pneumococcus infection, most strains isolated were penicillin non-susceptible. 28,29 After PCV7 implementation, serotype 19A became the most frequently isolated serotype with AOM treatment failure.…”

“…28,37 By contrast, for pneumococcus infection, most strains isolated were penicillin non-susceptible. 28,29 After PCV7 implementation, serotype 19A became the most frequently isolated serotype with AOM treatment failure. 29 This finding is not surprising because of the role of serotype 19A in AOM, 20,21 its frequent multi-resistance to antibiotics 38 and its emergence after PCV7 implementation.…”

“…14,15 To determine the impact of the PCVs in France, several surveillance systems of pneumococcal infection and carriage were established before and after PCV implementation. 11,13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] All these studies were approved by the French National Data Protection Commission (CNIL) and/or the French Ethics Committee. Most of the studies were requested by the European Agency for the Evaluation of Medicinal Products as a post-licensing commitment.…”

“…In the early 2000s, a national NP study has started to complete the epidemiological surveillance of pneumococcus. [18][19][20][21][22][23]28 Since 2001, 121 pediatricians who are part of the research and teaching ACTIV network throughout France have participated in a prospective NP carriage study. 23 From October to June of each year, 700 children of both sexes with suppurative AOM with fever and/ or otalgia (to increase the probability of pneumococcal AOM), 6 to 24 months old, were enrolled by pediatricians in pediatric outpatient clinics.…”

“…28,29,[33][34][35][36] Antibiotic treatment failure was defined as the persistence of AOM symptoms after at least 48 hours of antibiotics or their recurrence within 4 d after the end of treatment. 29 Middle ear fluid (MEF) was obtained by tympanocentesis and/or by sampling spontaneous discharge according to recommended clinical practice guidelines.…”