TY - JOUR
TI - Multinational study of pneumococcal serotypes causing acute otitis media
in children
AU - Hausdorff, WP
AU - Yothers, G
AU - Dagan, R
AU - Kilpi, T
AU - Pelton, SI
AU - and Cohen, R
AU - Jacobs, MR
AU - Kaplan, SL
AU - Levy, C
AU - Lopez, EL and
AU - Mason, EO
AU - Syriopoulou, V
AU - Wynne, B
AU - Bryant, J
JO - The Pediatric Infectious Disease Journal
PY - 2002
VL - 21
TODO - 11
SP - 1008-1016
PB - Lippincott, Williams & Wilkins
SN - 0891-3668, 1532-0987
TODO - 10.1097/00006454-200211000-00007
TODO - Pneumococcus; acute otitis media; serotypes
TODO - Background. Streptococcus pneumoniae is a major cause of acute otitis
media (AOM) in young children. More than 90 immunologically distinct
pneumococcal serotypes have been identified, but limited information is
available regarding their relative importance in AOM.
Methods. We analyzed nine existing datasets comprising pneumococcal
isolates from middle ear fluid samples collected from 1994 through 2000
from 3232 children with AOM from Finland, France, Greece, Israel,
several East European countries, the US and Argentina. We examined the
distribution of pneumococcal serotypes in relation to several
demographic and epidemiologic variables, including gender, age,
antibiotic resistance and source of culture material.
Results. The major serotypes identified included 19F and 23F, each
comprising 13 to 25% of pneumococcal middle ear fluid isolates in most
datasets; 14 and 6B, comprising 6 to 18%; whereas 6A, 19A and 9V each
comprised 5 to 10%. Despite differences in location, study design and
antibiotic susceptibility, each major serotype was prominent in most age
groups of each dataset. Serotypes represented in the 7-valent
pneumococcal conjugate vaccine (PCV-7, 4, 6B, 9V, 14, 18C, 19F, 23F)
accounted for 60 to 70% of all pneumococcal isolates in the 6- to
59-month age range, but only 40 to 50% of isolates in children <6 or
greater than or equal to60 months old. Serotype 3 and, in certain
datasets, serotypes 1 and 5, were more important in the <6- and greater
than or equal to60-month age groups. In each age group vaccine-related
serotypes (mainly 6A and 19A) comprised an additional 10 to 15% of all
pneumococcal isolates. Four serotypes (23F, 19F, 14 and 6B) accounted
for 83% of all penicillin-resistant observations.
Conclusions. This analysis of several geographically diverse datasets
indicates that a limited number of serotypes, largely represented in
PCV-7, accounted for the majority of episodes of pneumococcal AOM in
children between 6 and 59 months of age. Certain serotypes appeared to
be relatively more significant in children <6 months or >59 months of
age.
ER -