Etiology of Acute Otitis Media and Characterization of Pneumococcal Isolates after Introduction of 13-Valent Pneumococcal Conjugate Vaccine in Japanese Children
BACKGROUND:Acute otitis media (AOM) is a leading cause of childhood morbidity and antibiotic prescriptions. We examined etiologic changes in AOM after introduction of 13-valent pneumococcal conjugate vaccine as routine immunization for Japanese children in 2014. Serotypes, resistance genotypes, anti...
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| Veröffentlicht in: | The Pediatric infectious disease journal 2018-06, Vol.37 (6), p.598-604 |
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| container_title | The Pediatric infectious disease journal |
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| creator | Ubukata, Kimiko Morozumi, Miyuki Sakuma, Megumi Takata, Misako Mokuno, Eriko Tajima, Takeshi Iwata, Satoshi |
| description | BACKGROUND:Acute otitis media (AOM) is a leading cause of childhood morbidity and antibiotic prescriptions. We examined etiologic changes in AOM after introduction of 13-valent pneumococcal conjugate vaccine as routine immunization for Japanese children in 2014. Serotypes, resistance genotypes, antibiotic susceptibilities, and multilocus sequence typing of pneumococcal isolates were also characterized.
METHODS:Otolaryngologists prospectively collected middle ear fluid from 582 children by tympanocentesis or sampling through a spontaneously ruptured tympanic membrane between June 2016 and January 2017. Causative pathogens were identified by bacterial culture and real-time PCR for bacteria. Serotypes, resistance genotypes, sequence types, and susceptibilities to14 antimicrobial agents were determined for pneumococcal isolates.
RESULTS:At least 1 bacterial pathogen was identified in 473 of the samples (81.3%). Nontypable Haemophilus influenzae (54.8%) was detected most frequently, followed by Streptococcus pneumoniae (25.4%), Streptococcus pyogenes (2.9%), and others. Pneumococci of current vaccine serotypes have decreased dramatically from 82.1% in 2006 to 18.5% (P |
| doi_str_mv | 10.1097/INF.0000000000001956 |
| format | Article |
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METHODS:Otolaryngologists prospectively collected middle ear fluid from 582 children by tympanocentesis or sampling through a spontaneously ruptured tympanic membrane between June 2016 and January 2017. Causative pathogens were identified by bacterial culture and real-time PCR for bacteria. Serotypes, resistance genotypes, sequence types, and susceptibilities to14 antimicrobial agents were determined for pneumococcal isolates.
RESULTS:At least 1 bacterial pathogen was identified in 473 of the samples (81.3%). Nontypable Haemophilus influenzae (54.8%) was detected most frequently, followed by Streptococcus pneumoniae (25.4%), Streptococcus pyogenes (2.9%), and others. Pneumococci of current vaccine serotypes have decreased dramatically from 82.1% in 2006 to 18.5% (P <0.001). Commonest serotypes were 15A (14.8%), 3 (13.9%), and 35B (11.1%). Serotype 3 was significantly less frequent among children receiving PCV13 compared with PCV7 (P = 0.002). Genotypic penicillin-resistant S. pneumoniae accounted for 28.7%, slightly less than in 2006 (34.2%; P = 0.393); the penicillin-resistant serotypes 15A and 35B had increased. Serotypes 15A, 3, and 35B most often belonged to sequence types 63, 180, and 558.
CONCLUSIONS:Our findings are expected to assist in development of future vaccines, and they underscore the need for appropriate clinical choice of oral agents based on testing of causative pathogens.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/INF.0000000000001956</identifier><identifier>PMID: 29474258</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adolescent ; Anti-Bacterial Agents - pharmacology ; Bacterial Typing Techniques ; Child ; Child, Preschool ; Epidemiological Monitoring ; Female ; Haemophilus influenzae - genetics ; Haemophilus influenzae - isolation & purification ; Humans ; Japan - epidemiology ; Male ; Microbial Sensitivity Tests ; Multilocus Sequence Typing ; Otitis Media - epidemiology ; Otitis Media - microbiology ; Otitis Media with Effusion - epidemiology ; Otitis Media with Effusion - microbiology ; Pneumococcal Infections - prevention & control ; Pneumococcal Vaccines - therapeutic use ; Polymerase Chain Reaction ; Prospective Studies ; Serogroup ; Streptococcus pneumoniae - classification ; Streptococcus pneumoniae - drug effects ; Streptococcus pneumoniae - isolation & purification</subject><ispartof>The Pediatric infectious disease journal, 2018-06, Vol.37 (6), p.598-604</ispartof><rights>Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4686-ded18d3ec73d10631c3c60065f725e18705d9e009e163392d61c93e23ad809033</citedby><cites>FETCH-LOGICAL-c4686-ded18d3ec73d10631c3c60065f725e18705d9e009e163392d61c93e23ad809033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29474258$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ubukata, Kimiko</creatorcontrib><creatorcontrib>Morozumi, Miyuki</creatorcontrib><creatorcontrib>Sakuma, Megumi</creatorcontrib><creatorcontrib>Takata, Misako</creatorcontrib><creatorcontrib>Mokuno, Eriko</creatorcontrib><creatorcontrib>Tajima, Takeshi</creatorcontrib><creatorcontrib>Iwata, Satoshi</creatorcontrib><creatorcontrib>AOM Surveillance Study Group</creatorcontrib><title>Etiology of Acute Otitis Media and Characterization of Pneumococcal Isolates after Introduction of 13-Valent Pneumococcal Conjugate Vaccine in Japanese Children</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>BACKGROUND:Acute otitis media (AOM) is a leading cause of childhood morbidity and antibiotic prescriptions. We examined etiologic changes in AOM after introduction of 13-valent pneumococcal conjugate vaccine as routine immunization for Japanese children in 2014. Serotypes, resistance genotypes, antibiotic susceptibilities, and multilocus sequence typing of pneumococcal isolates were also characterized.
METHODS:Otolaryngologists prospectively collected middle ear fluid from 582 children by tympanocentesis or sampling through a spontaneously ruptured tympanic membrane between June 2016 and January 2017. Causative pathogens were identified by bacterial culture and real-time PCR for bacteria. Serotypes, resistance genotypes, sequence types, and susceptibilities to14 antimicrobial agents were determined for pneumococcal isolates.
RESULTS:At least 1 bacterial pathogen was identified in 473 of the samples (81.3%). Nontypable Haemophilus influenzae (54.8%) was detected most frequently, followed by Streptococcus pneumoniae (25.4%), Streptococcus pyogenes (2.9%), and others. Pneumococci of current vaccine serotypes have decreased dramatically from 82.1% in 2006 to 18.5% (P <0.001). Commonest serotypes were 15A (14.8%), 3 (13.9%), and 35B (11.1%). Serotype 3 was significantly less frequent among children receiving PCV13 compared with PCV7 (P = 0.002). Genotypic penicillin-resistant S. pneumoniae accounted for 28.7%, slightly less than in 2006 (34.2%; P = 0.393); the penicillin-resistant serotypes 15A and 35B had increased. Serotypes 15A, 3, and 35B most often belonged to sequence types 63, 180, and 558.
CONCLUSIONS:Our findings are expected to assist in development of future vaccines, and they underscore the need for appropriate clinical choice of oral agents based on testing of causative pathogens.</description><subject>Adolescent</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Bacterial Typing Techniques</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Epidemiological Monitoring</subject><subject>Female</subject><subject>Haemophilus influenzae - genetics</subject><subject>Haemophilus influenzae - isolation & purification</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Microbial Sensitivity Tests</subject><subject>Multilocus Sequence Typing</subject><subject>Otitis Media - epidemiology</subject><subject>Otitis Media - microbiology</subject><subject>Otitis Media with Effusion - epidemiology</subject><subject>Otitis Media with Effusion - microbiology</subject><subject>Pneumococcal Infections - prevention & control</subject><subject>Pneumococcal Vaccines - therapeutic use</subject><subject>Polymerase Chain Reaction</subject><subject>Prospective Studies</subject><subject>Serogroup</subject><subject>Streptococcus pneumoniae - classification</subject><subject>Streptococcus pneumoniae - drug effects</subject><subject>Streptococcus pneumoniae - isolation & purification</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90UFPFDEUB_DGaGRBv4ExPXoZfJ3OdNoj2YCsQfCgXCe1fcMWu-3adkLw0_BRKVkw4sFeevn932v6J-Qdg0MGavi4Oj85hL8OU714QRas520DSg4vyQKkYg0XQu6R_ZyvK-Idg9dkr1Xd0LW9XJC74-Kij1e3NE70yMwF6UVxxWX6Ba3TVAdLl2udtCmY3G9ddXigXwPOm2iiMdrTVY5eF8xUT1XRVSgp2tk8WcabS-0xlOepZQzX81XN0UttjAtIXaCf9VYHzFiXOm8Thjfk1aR9xreP9wH5fnL8bXnanF18Wi2PzhrTCSkai5ZJy9EM3DIQnBluBIDop6HtkckBeqsQQCETnKvWCmYUx5ZrK0EB5wfkw27uNsVfM-Yyblw26H19Tpzz2AIMSsq2F5V2O2pSzDnhNG6T2-h0OzIYH7oZazfjv93U2PvHDfOPDdo_oacyKpA7cBN9_cf80883mMY1al_W_599D_BGnBo</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Ubukata, Kimiko</creator><creator>Morozumi, Miyuki</creator><creator>Sakuma, Megumi</creator><creator>Takata, Misako</creator><creator>Mokuno, Eriko</creator><creator>Tajima, Takeshi</creator><creator>Iwata, Satoshi</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180601</creationdate><title>Etiology of Acute Otitis Media and Characterization of Pneumococcal Isolates after Introduction of 13-Valent Pneumococcal Conjugate Vaccine in Japanese Children</title><author>Ubukata, Kimiko ; Morozumi, Miyuki ; Sakuma, Megumi ; Takata, Misako ; Mokuno, Eriko ; Tajima, Takeshi ; Iwata, Satoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4686-ded18d3ec73d10631c3c60065f725e18705d9e009e163392d61c93e23ad809033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Bacterial Typing Techniques</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Epidemiological Monitoring</topic><topic>Female</topic><topic>Haemophilus influenzae - genetics</topic><topic>Haemophilus influenzae - isolation & purification</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Microbial Sensitivity Tests</topic><topic>Multilocus Sequence Typing</topic><topic>Otitis Media - epidemiology</topic><topic>Otitis Media - microbiology</topic><topic>Otitis Media with Effusion - epidemiology</topic><topic>Otitis Media with Effusion - microbiology</topic><topic>Pneumococcal Infections - prevention & control</topic><topic>Pneumococcal Vaccines - therapeutic use</topic><topic>Polymerase Chain Reaction</topic><topic>Prospective Studies</topic><topic>Serogroup</topic><topic>Streptococcus pneumoniae - classification</topic><topic>Streptococcus pneumoniae - drug effects</topic><topic>Streptococcus pneumoniae - isolation & purification</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ubukata, Kimiko</creatorcontrib><creatorcontrib>Morozumi, Miyuki</creatorcontrib><creatorcontrib>Sakuma, Megumi</creatorcontrib><creatorcontrib>Takata, Misako</creatorcontrib><creatorcontrib>Mokuno, Eriko</creatorcontrib><creatorcontrib>Tajima, Takeshi</creatorcontrib><creatorcontrib>Iwata, Satoshi</creatorcontrib><creatorcontrib>AOM Surveillance Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ubukata, Kimiko</au><au>Morozumi, Miyuki</au><au>Sakuma, Megumi</au><au>Takata, Misako</au><au>Mokuno, Eriko</au><au>Tajima, Takeshi</au><au>Iwata, Satoshi</au><aucorp>AOM Surveillance Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Etiology of Acute Otitis Media and Characterization of Pneumococcal Isolates after Introduction of 13-Valent Pneumococcal Conjugate Vaccine in Japanese Children</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>37</volume><issue>6</issue><spage>598</spage><epage>604</epage><pages>598-604</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><abstract>BACKGROUND:Acute otitis media (AOM) is a leading cause of childhood morbidity and antibiotic prescriptions. We examined etiologic changes in AOM after introduction of 13-valent pneumococcal conjugate vaccine as routine immunization for Japanese children in 2014. Serotypes, resistance genotypes, antibiotic susceptibilities, and multilocus sequence typing of pneumococcal isolates were also characterized.
METHODS:Otolaryngologists prospectively collected middle ear fluid from 582 children by tympanocentesis or sampling through a spontaneously ruptured tympanic membrane between June 2016 and January 2017. Causative pathogens were identified by bacterial culture and real-time PCR for bacteria. Serotypes, resistance genotypes, sequence types, and susceptibilities to14 antimicrobial agents were determined for pneumococcal isolates.
RESULTS:At least 1 bacterial pathogen was identified in 473 of the samples (81.3%). Nontypable Haemophilus influenzae (54.8%) was detected most frequently, followed by Streptococcus pneumoniae (25.4%), Streptococcus pyogenes (2.9%), and others. Pneumococci of current vaccine serotypes have decreased dramatically from 82.1% in 2006 to 18.5% (P <0.001). Commonest serotypes were 15A (14.8%), 3 (13.9%), and 35B (11.1%). Serotype 3 was significantly less frequent among children receiving PCV13 compared with PCV7 (P = 0.002). Genotypic penicillin-resistant S. pneumoniae accounted for 28.7%, slightly less than in 2006 (34.2%; P = 0.393); the penicillin-resistant serotypes 15A and 35B had increased. Serotypes 15A, 3, and 35B most often belonged to sequence types 63, 180, and 558.
CONCLUSIONS:Our findings are expected to assist in development of future vaccines, and they underscore the need for appropriate clinical choice of oral agents based on testing of causative pathogens.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>29474258</pmid><doi>10.1097/INF.0000000000001956</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Anti-Bacterial Agents - pharmacology Bacterial Typing Techniques Child Child, Preschool Epidemiological Monitoring Female Haemophilus influenzae - genetics Haemophilus influenzae - isolation & purification Humans Japan - epidemiology Male Microbial Sensitivity Tests Multilocus Sequence Typing Otitis Media - epidemiology Otitis Media - microbiology Otitis Media with Effusion - epidemiology Otitis Media with Effusion - microbiology Pneumococcal Infections - prevention & control Pneumococcal Vaccines - therapeutic use Polymerase Chain Reaction Prospective Studies Serogroup Streptococcus pneumoniae - classification Streptococcus pneumoniae - drug effects Streptococcus pneumoniae - isolation & purification |
| title | Etiology of Acute Otitis Media and Characterization of Pneumococcal Isolates after Introduction of 13-Valent Pneumococcal Conjugate Vaccine in Japanese Children |
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