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Impact of Pneumococcal Conjugate Vaccines on Microbial Epidemiology and Clinical Outcomes of Acute Otitis Media

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Abstract

Acute otitis media (AOM) is the leading bacterial infection in childhood and the main reason for antibiotic prescriptions in children. The success of pneumococcal conjugate vaccines (PCVs) in reducing invasive pneumococcal disease has been demonstrated in many studies. Because Streptococcus pneumoniae is one of the two main bacterial species implicated in AOM, the incidence and characteristics of AOM might also be modified by PCVs. Pre-licensure controlled studies showed that the effect was modest. However, after PCV7 implementation, the impact on the AOM burden appeared to be more marked, despite the fact that serotype replacement in the nasopharynx was almost complete. Most data on the impact of PCVs on nasopharyngeal flora have been drawn from studies with PCV7. No difference was observed with PCV10 compared with PCV7 concerning S. pneumoniae and Haemophilus influenza carriage. For PCV13 compared with PCV7, additional reduction of carriage of serotypes 1, 6A, 7F, 6C, 19A, and 19F was observed, but for the other serotypes, the two PCVs seemed to have the same effect.

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References

  1. Vergison A, Dagan R, Arguedas A, Bonhoeffer J, Cohen R, Dhooge I, et al. Otitis media and its consequences: beyond the earache. Lancet Infect Dis. 2010;10(3):195–203. doi:10.1016/S1473-3099(10)70012-8.

    Article  PubMed  Google Scholar 

  2. Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, et al. Treatment of acute otitis media in children under 2 years of age. N Engl J Med. 2011;364(2):105–15. doi:10.1056/NEJMoa0912254.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Fletcher MA, Fritzell B. Brief review of the clinical effectiveness of Prevenar against otitis media. Vaccine. 2007;25(13):2507–12. doi:10.1016/j.vaccine.2006.09.027.

    Article  CAS  PubMed  Google Scholar 

  4. Forsgren A, Riesbeck K, Janson H. Protein D of Haemophilus influenzae: a protective nontypeable H. influenzae antigen and a carrier for pneumococcal conjugate vaccines. Clin Infect Dis. 2008;46(5):726–31. doi:10.1086/527396.

    Article  CAS  PubMed  Google Scholar 

  5. Scott DA, Komjathy SF, Hu BT, Baker S, Supan LA, Monahan CA, et al. Phase 1 trial of a 13-valent pneumococcal conjugate vaccine in healthy adults. Vaccine. 2007;25(33):6164–6. doi:10.1016/j.vaccine.2007.06.004.

    Article  CAS  PubMed  Google Scholar 

  6. Pilishvili T, Lexau C, Farley MM, Hadler J, Harrison LH, Bennett NM, et al. Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. J Infect Dis. 2010;201(1):32–41. doi:10.1086/648593.

    Article  PubMed  Google Scholar 

  7. Black S, Shinefield H, Fireman B, Lewis E, Ray P, Hansen JR, et al. Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group. Pediatr Infect Dis J. 2000;19(3):187–95.

    Article  CAS  PubMed  Google Scholar 

  8. Hicks LA, Harrison LH, Flannery B, Hadler JL, Schaffner W, Craig AS, et al. Incidence of pneumococcal disease due to non-pneumococcal conjugate vaccine (PCV7) serotypes in the United States during the era of widespread PCV7 vaccination, 1998–2004. J Infect Dis. 2007;196(9):1346–54. doi:10.1086/521626.

    Article  PubMed  Google Scholar 

  9. Gladstone RA, Jefferies JM, Faust SN, Clarke SC. Continued control of pneumococcal disease in the UK—the impact of vaccination. J Med Microbiol. 2011;60(Pt 1):1–8. doi:10.1099/jmm.0.020016-0.

    Article  CAS  PubMed  Google Scholar 

  10. Miller E, Andrews NJ, Waight PA, Slack MP, George RC. Effectiveness of the new serotypes in the 13-valent pneumococcal conjugate vaccine. Vaccine. 2011;29(49):9127–31. doi:10.1016/j.vaccine.2011.09.112.

    Article  CAS  PubMed  Google Scholar 

  11. O’Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, McCall N, et al. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet. 2009;374(9693):893–902. doi:10.1016/S0140-6736(09)61204-6.

    Article  PubMed  Google Scholar 

  12. Simell B, Auranen K, Kayhty H, Goldblatt D, Dagan R, O’Brien KL. The fundamental link between pneumococcal carriage and disease. Expert Rev Vaccines. 2012;11(7):841–55. doi:10.1586/erv.12.53.

    Article  CAS  PubMed  Google Scholar 

  13. Bogaert D, De Groot R, Hermans PW. Streptococcus pneumoniae colonisation: the key to pneumococcal disease. Lancet Infect Dis. 2004;4(3):144–54. doi:10.1016/S1473-3099(04)00938-7.

    Article  CAS  PubMed  Google Scholar 

  14. Bogaert D, Keijser B, Huse S, Rossen J, Veenhoven R, van Gils E, et al. Variability and diversity of nasopharyngeal microbiota in children: a metagenomic analysis. PLoS One. 2011;6(2):e17035. doi:10.1371/journal.pone.0017035.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Aguilar L, Alvarado O, Soley C, Abdelnour A, Dagan R, Arguedas A. Microbiology of the middle ear fluid in Costa Rican children between 2002 and 2007. Int J Pediatr Otorhinolaryngol. 2009;73(10):1407–11. doi:10.1016/j.ijporl.2009.07.005.

    Article  PubMed  Google Scholar 

  16. Garcia-Rodriguez JA, Fresnadillo Martinez MJ. Dynamics of nasopharyngeal colonization by potential respiratory pathogens. J Antimicrob Chemother. 2002;50(Suppl S2):59–73.

    Article  CAS  PubMed  Google Scholar 

  17. Gray BM, Converse GM 3rd, Dillon HC Jr. Epidemiologic studies of Streptococcus pneumoniae in infants: acquisition, carriage, and infection during the first 24 months of life. J Infect Dis. 1980;142(6):923–33.

    Article  CAS  PubMed  Google Scholar 

  18. Gray BM, Dillon HC Jr. Natural history of pneumococcal infections. Pediatr Infect Dis J. 1989;8(1 Suppl):S23–5.

    CAS  PubMed  Google Scholar 

  19. Hanage WP. Serotype-specific problems associated with pneumococcal conjugate vaccination. Future Microbiol. 2008;3(1):23–30. doi:10.2217/17460913.3.1.23.

    Article  PubMed  Google Scholar 

  20. Hanage WP, Finkelstein JA, Huang SS, Pelton SI, Stevenson AE, Kleinman K, et al. Evidence that pneumococcal serotype replacement in Massachusetts following conjugate vaccination is now complete. Epidemics. 2010;2(2):80–4. doi:10.1016/j.epidem.2010.03.005.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Cohen R, Levy C, Bonnet E, Grondin S, Desvignes V, Lecuyer A, et al. Dynamic of pneumococcal nasopharyngeal carriage in children with acute otitis media following PCV7 introduction in France. Vaccine. 2010;28(37):6114–21. doi:10.1016/j.vaccine.2009.05.037.

    Article  CAS  PubMed  Google Scholar 

  22. Shouval DS, Greenberg D, Givon-Lavi N, Porat N, Dagan R. Site-specific disease potential of individual Streptococcus pneumoniae serotypes in pediatric invasive disease, acute otitis media and acute conjunctivitis. Pediatr Infect Dis J. 2006;25(7):602–7. doi:10.1097/01.inf.0000220231.79968.f6.

    Article  PubMed  Google Scholar 

  23. Dagan R, Klugman KP. Impact of conjugate pneumococcal vaccines on antibiotic resistance. Lancet Infect Dis. 2008;8(12):785–95. doi:10.1016/S1473-3099(08)70281-0.

    Article  PubMed  Google Scholar 

  24. Song JH, Dagan R, Klugman KP, Fritzell B. The relationship between pneumococcal serotypes and antibiotic resistance. Vaccine. 2012;30(17):2728–37. doi:10.1016/j.vaccine.2012.01.091.

    Article  CAS  PubMed  Google Scholar 

  25. Cohen R, Levy C, de La Rocque F, Gelbert N, Wollner A, Fritzell B, et al. Impact of pneumococcal conjugate vaccine and of reduction of antibiotic use on nasopharyngeal carriage of nonsusceptible pneumococci in children with acute otitis media. Pediatr Infect Dis J. 2006;25(11):1001–7. doi:10.1097/01.inf.0000243163.85163.a8.

    Article  PubMed  Google Scholar 

  26. Casey J, Kaur R, Friedel V, Pichichero M. Acute otitis media otopathogens during 2008–2010 in Rochester NY. Pediatr Infect Dis J. 2013;. doi:10.1097:INF.0b013e31828d9acc.

    Google Scholar 

  27. Friedel V, Chang A, Wills J, Vargas R, Xu Q, Pichichero ME. Impact of respiratory viral infections on alpha-hemolytic streptococci and otopathogens in the nasopharynx of young children. Pediatr Infect Dis J. 2013;32(1):27–31. doi:10.1097/INF.0b013e31826f6144.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Xu Q, Almudervar A, Casey JR, Pichichero ME. Nasopharyngeal bacterial interactions in children. Emerg Infect Dis. 2012;18(11):1738–45. doi:10.3201/eid1811.111904.

    Article  PubMed  Google Scholar 

  29. Xu Q, Casey JR, Chang A, Pichichero ME. When co-colonizing the nasopharynx Haemophilus influenzae predominates over Streptococcus pneumoniae except serotype 19A strains to cause acute otitis media. Pediatr Infect Dis J. 2012;31(6):638–40. doi:10.1097/INF.0b013e31824ba6f7.

    Article  PubMed Central  PubMed  Google Scholar 

  30. van Gils EJ, Hak E, Veenhoven RH, Rodenburg GD, Bogaert D, Bruin JP, et al. Effect of seven-valent pneumococcal conjugate vaccine on Staphylococcus aureus colonisation in a randomised controlled trial. PLoS One. 2011;6(6):e20229. doi:10.1371/journal.pone.0020229.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Regev-Yochay G, Raz M, Dagan R, Porat N, Shainberg B, Pinco E, et al. Nasopharyngeal carriage of Streptococcus pneumoniae by adults and children in community and family settings. Clin Infect Dis. 2004;38(5):632–9. doi:10.1086/381547.

    Article  PubMed  Google Scholar 

  32. Bogaert D, van Belkum A, Sluijter M, Luijendijk A, de Groot R, Rumke HC, et al. Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children. Lancet. 2004;363(9424):1871–2. doi:10.1016/S0140-6736(04)16357-5.

    Article  CAS  PubMed  Google Scholar 

  33. Madhi SA, Adrian P, Kuwanda L, Cutland C, Albrich WC, Klugman KP. Long-term effect of pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae—and associated interactions with Staphylococcus aureus and Haemophilus influenzae colonization—in HIV-infected and HIV-uninfected children. J Infect Dis. 2007;196(11):1662–6. doi:10.1086/522164.

    Article  PubMed  Google Scholar 

  34. Cohen R, Levy C, Thollot F, de La Rocque F, Koskas M, Bonnet E, et al. Pneumococcal conjugate vaccine does not influence Staphylococcus aureus carriage in young children with acute otitis media. Clin Infect Dis. 2007;45(12):1583–7. doi:10.1086/523734.

    Article  PubMed  Google Scholar 

  35. Spijkerman J, Prevaes SM, van Gils EJ, Veenhoven RH, Bruin JP, Bogaert D, et al. Long-term effects of pneumococcal conjugate vaccine on nasopharyngeal carriage of S. pneumoniae, S. aureus, H. influenzae and M. catarrhalis. PLoS One. 2012;7(6):e39730. doi:10.1371/journal.pone.0039730.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Cohen R, Bingen E, Levy C, Thollot F, Boucherat M, Derkx V, et al. Nasopharyngeal flora in children with acute otitis media before and after implementation of 7 valent pneumococcal conjugate vaccine in France. BMC Infect Dis. 2012;12:52. doi:10.1186/1471-2334-12-52.

    Article  PubMed Central  PubMed  Google Scholar 

  37. van Gils EJ, Veenhoven RH, Rodenburg GD, Hak E, Sanders EA. Effect of 7-valent pneumococcal conjugate vaccine on nasopharyngeal carriage with Haemophilus influenzae and Moraxella catarrhalis in a randomized controlled trial. Vaccine. 2011;29(44):7595–8. doi:10.1016/j.vaccine.2011.08.049.

    Article  PubMed  Google Scholar 

  38. Hilty M, Qi W, Brugger SD, Frei L, Agyeman P, Frey PM, et al. Nasopharyngeal microbiota in infants with acute otitis media. J Infect Dis. 2012;205(7):1048–55. doi:10.1093/infdis/jis024.

    Article  CAS  PubMed  Google Scholar 

  39. Laufer AS, Metlay JP, Gent JF, Fennie KP, Kong Y, Pettigrew MM. Microbial communities of the upper respiratory tract and otitis media in children. MBio. 2011;2(1):e00245–310. doi:10.1128/mBio.00245-10.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Lemon KP, Klepac-Ceraj V, Schiffer HK, Brodie EL, Lynch SV, Kolter R. Comparative analyses of the bacterial microbiota of the human nostril and oropharynx. MBio. 2010;1(3):e00129–210. doi:10.1128/mBio.00129-10.

    PubMed Central  PubMed  Google Scholar 

  41. Pettigrew MM, Gent JF, Pyles RB, Miller AL, Nokso-Koivisto J, Chonmaitree T. Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection. J Clin Microbiol. 2011;49(11):3750–5. doi:10.1128/JCM.01186-11.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Pettigrew MM, Gent JF, Revai K, Patel JA, Chonmaitree T. Microbial interactions during upper respiratory tract infections. Emerg Infect Dis. 2008;14(10):1584–91. doi:10.3201/eid1410.080119.

    Article  PubMed  Google Scholar 

  43. Pettigrew MM, Laufer AS, Gent JF, Kong Y, Fennie KP, Metlay JP. Upper respiratory tract microbial communities, acute otitis media pathogens, and antibiotic use in healthy and sick children. Appl Environ Microbiol. 2012;78(17):6262–70. doi:10.1128/AEM.01051-12.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  44. Revai K, Mamidi D, Chonmaitree T. Association of nasopharyngeal bacterial colonization during upper respiratory tract infection and the development of acute otitis media. Clin Infect Dis. 2008;46(4):e34–7. doi:10.1086/525856.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Ruohola A, Pettigrew MM, Lindholm L, Jalava J, Raisanen KS, Vainionpaa R, et al. Bacterial and viral interactions within the nasopharynx contribute to the risk of acute otitis media. J Infect. 2013;66(3):247–54. doi:10.1016/j.jinf.2012.12.002.

    Article  PubMed  Google Scholar 

  46. van den Bergh MR, Spijkerman J, Swinnen KM, Francois NA, Pascal TG, Borys D, et al. Effects of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D-conjugate vaccine on nasopharyngeal bacterial colonization in young children: a randomized controlled trial. Clin Infect Dis. 2013;56(3):e30–9. doi:10.1093/cid/cis922.

    Article  PubMed  Google Scholar 

  47. Cohen R, Levy C, Bingen E, Koskas M, Nave I, Varon E. Impact of 13-valent pneumococcal conjugate vaccine on pneumococcal nasopharyngeal carriage in children with acute otitis media. Pediatr Infect Dis J. 2012;31(3):297–301. doi:10.1097/INF.0b013e318247ef84.

    Article  PubMed  Google Scholar 

  48. Dagan R, Patterson S, Juergens C, Greenberg D, Givon-Lavi N, Porat N, et al. Comparative immunogenicity and efficacy of 13-valent and 7-valent pneumococcal conjugate vaccine in reducing nasopharyngeal colonization: a randomized double-blind trial. Clin Infect Dis. 2013;. doi:10.1093/cid/cit428.

    PubMed  Google Scholar 

  49. O’Brien KL, David AB, Chandran A, Moulton LH, Reid R, Weatherholtz R, et al. Randomized, controlled trial efficacy of pneumococcal conjugate vaccine against otitis media among Navajo and White Mountain Apache infants. Pediatr Infect Dis J. 2008;27(1):71–3. doi:10.1097/INF.0b013e318159228f.

    Article  PubMed  Google Scholar 

  50. Kilpi T, Ahman H, Jokinen J, Lankinen KS, Palmu A, Savolainen H, et al. Protective efficacy of a second pneumococcal conjugate vaccine against pneumococcal acute otitis media in infants and children: randomized, controlled trial of a 7-valent pneumococcal polysaccharide-meningococcal outer membrane protein complex conjugate vaccine in 1666 children. Clin Infect Dis. 2003;37(9):1155–64. doi:10.1086/378744.

    Article  CAS  PubMed  Google Scholar 

  51. Eskola J, Kilpi T, Palmu A, Jokinen J, Haapakoski J, Herva E, et al. Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med. 2001;344(6):403–9. doi:10.1056/NEJM200102083440602.

    Article  CAS  PubMed  Google Scholar 

  52. Prymula R, Peeters P, Chrobok V, Kriz P, Novakova E, Kaliskova E, et al. Pneumococcal capsular polysaccharides conjugated to protein D for prevention of acute otitis media caused by both Streptococcus pneumoniae and non-typable Haemophilus influenzae: a randomised double-blind efficacy study. Lancet. 2006;367(9512):740–8. doi:10.1016/S0140-6736(06)68304-9.

    Article  CAS  PubMed  Google Scholar 

  53. Fireman B, Black SB, Shinefield HR, Lee J, Lewis E, Ray P. Impact of the pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J. 2003;22(1):10–6. doi:10.1097/01.inf.0000045221.96634.7c.

    Article  PubMed  Google Scholar 

  54. Dagan R, Sikuler-Cohen M, Zamir O, Janco J, Givon-Lavi N, Fraser D. Effect of a conjugate pneumococcal vaccine on the occurrence of respiratory infections and antibiotic use in day-care center attendees. Pediatr Infect Dis J. 2001;20(10):951–8.

    Article  CAS  PubMed  Google Scholar 

  55. GlaxoSmithKline. Result summary for 109563. http://www.gsk-clinicalstudyregister.com/result_detail.jsp?protocolId=109563&studyId=4C067737-D005-43ED-9C26-909AC9413566&compound=Pneumococcal+Polysaccharide+Conjugate+Vaccine+(Adsorbed). Accessed 3 Aug 2013.

  56. De Wals P, Erickson L, Poirier B, Pepin J, Pichichero ME. How to compare the efficacy of conjugate vaccines to prevent acute otitis media? Vaccine. 2009;27(21):2877–83. doi:10.1016/j.vaccine.2009.02.102.

    Article  PubMed  Google Scholar 

  57. Jokinen J, Palmu AA, Kilpi T. Acute otitis media replacement and recurrence in the Finnish Otitis Media Vaccine Trial. Clin Infect Dis. 2012;55(12):1673–6. doi:10.1093/cid/cis799.

    Article  CAS  PubMed  Google Scholar 

  58. Sarasoja I, Jokinen J, Lahdenkari M, Kilpi T, Palmu AA. Long-term effect of pneumococcal conjugate vaccines on tympanostomy tube placements. Pediatr Infect Dis J. 2013;32(5):517–20. doi:10.1097/INF.0b013e31827c9bcc.

    Article  PubMed  Google Scholar 

  59. Esposito S, Lizioli A, Lastrico A, Begliatti E, Rognoni A, Tagliabue C, et al. Impact on respiratory tract infections of heptavalent pneumococcal conjugate vaccine administered at 3, 5 and 11 months of age. Respir Res. 2007;8:12. doi:10.1186/1465-9921-8-12.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Adam D, Fehnle K. Safety and effectiveness against respiratory tract infections for pneumococcal conjugate vaccine co-administered with routine vaccine combinations. Vaccine. 2008;26(47):5944–51. doi:10.1016/j.vaccine.2008.08.058.

    Article  CAS  PubMed  Google Scholar 

  61. Zhou F, Shefer A, Kong Y, Nuorti JP. Trends in acute otitis media-related health care utilization by privately insured young children in the United States, 1997–2004. Pediatrics. 2008;121(2):253–60. doi:10.1542/peds.2007-0619.

    Article  PubMed  Google Scholar 

  62. Wals PD, Carbon M, Sevin E, Deceuninck G, Ouakki M. Reduced physician claims for otitis media after implementation of pneumococcal conjugate vaccine program in the province of Quebec, Canada. Pediatr Infect Dis J. 2009;28(9):e271–5. doi:10.1097/INF.0b013e3181bad212.

    Article  PubMed  Google Scholar 

  63. Singleton RJ, Holman RC, Plant R, Yorita KL, Holve S, Paisano EL, et al. Trends in otitis media and myringtomy with tube placement among American Indian/Alaska Native children and the US general population of children. Pediatr Infect Dis J. 2009;28(2):102–7. doi:10.1097/INF.0b013e318188d079.

    Article  PubMed  Google Scholar 

  64. Poehling KA, Szilagyi PG, Grijalva CG, Martin SW, LaFleur B, Mitchel E, et al. Reduction of frequent otitis media and pressure-equalizing tube insertions in children after introduction of pneumococcal conjugate vaccine. Pediatrics. 2007;119(4):707–15. doi:10.1542/peds.2006-2138.

    Article  PubMed  Google Scholar 

  65. Grijalva CG, Poehling KA, Nuorti JP, Zhu Y, Martin SW, Edwards KM, et al. National impact of universal childhood immunization with pneumococcal conjugate vaccine on outpatient medical care visits in the United States. Pediatrics. 2006;118(3):865–73. doi:10.1542/peds.2006-0492.

    Article  PubMed  Google Scholar 

  66. Casey JR, Pichichero ME. Changes in frequency and pathogens causing acute otitis media in 1995–2003. Pediatr Infect Dis J. 2004;23(9):824–8.

    Article  PubMed  Google Scholar 

  67. Taylor S, Marchisio P, Vergison A, Harriague J, Hausdorff WP, Haggard M. Impact of pneumococcal conjugate vaccination on otitis media: a systematic review. Clin Infect Dis. 2012;54(12):1765–73. doi:10.1093/cid/cis292.

    Article  PubMed  Google Scholar 

  68. Stamboulidis K, Chatzaki D, Poulakou G, Ioannidou S, Lebessi E, Katsarolis I, et al. The impact of the heptavalent pneumococcal conjugate vaccine on the epidemiology of acute otitis media complicated by otorrhea. Pediatr Infect Dis J. 2011;30(7):551–5. doi:10.1097/INF.0b013e31821038d9.

    Article  PubMed  Google Scholar 

  69. Manzoli L, Schioppa F, Boccia A, Villari P. The efficacy of influenza vaccine for healthy children: a meta-analysis evaluating potential sources of variation in efficacy estimates including study quality. Pediatr Infect Dis J. 2007;26(2):97–106. doi:10.1097/01.inf.0000253053.01151.bd.

    Article  PubMed  Google Scholar 

  70. Leibovitz E, Jacobs MR, Dagan R. Haemophilus influenzae: a significant pathogen in acute otitis media. Pediatr Infect Dis J. 2004;23(12):1142–52.

    PubMed  Google Scholar 

  71. Howie VM, Ploussard JH, Lester RL Jr. Otitis media: a clinical and bacteriological correlation. Pediatrics. 1970;45(1):29–35.

    CAS  PubMed  Google Scholar 

  72. Broides A, Dagan R, Greenberg D, Givon-Lavi N, Leibovitz E. Acute otitis media caused by Moraxella catarrhalis: epidemiologic and clinical characteristics. Clin Infect Dis. 2009;49(11):1641–7. doi:10.1086/647933.

    Article  PubMed  Google Scholar 

  73. Wald ER, Demuri GP. Antibiotic recommendations for acute otitis media and acute bacterial sinusitis in 2013—the conundrum. Pediatr Infect Dis J. 2013;32(6):641–3. doi:10.1097/INF.0b013e3182868cc8.

    Article  PubMed  Google Scholar 

  74. McEllistrem MC, Adams JM, Patel K, Mendelsohn AB, Kaplan SL, Bradley JS, et al. Acute otitis media due to penicillin-nonsusceptible Streptococcus pneumoniae before and after the introduction of the pneumococcal conjugate vaccine. Clin Infect Dis. 2005;40(12):1738–44. doi:10.1086/429908.

    Article  PubMed  Google Scholar 

  75. Block SL, Hedrick J, Harrison CJ, Tyler R, Smith A, Findlay R, et al. Community-wide vaccination with the heptavalent pneumococcal conjugate significantly alters the microbiology of acute otitis media. Pediatr Infect Dis J. 2004;23(9):829–33.

    Article  PubMed  Google Scholar 

  76. McEllistrem MC, Adams J, Mason EO, Wald ER. Epidemiology of acute otitis media caused by Streptococcus pneumoniae before and after licensure of the 7-valent pneumococcal protein conjugate vaccine. J Infect Dis. 2003;188(11):1679–84. doi:10.1086/379665.

    Article  CAS  PubMed  Google Scholar 

  77. Mahjoub-Messai F, Doit C, Mariani-Kurkdjian P, Francois M, Bingen E. Epidemiology of acute otitis media caused by Streptococcus pneumoniae: emergence of serotype 19A [in French]. Arch Pediatr. 2008;15(11):1713–6. doi:10.1016/j.arcped.2008.09.003.

    Article  CAS  PubMed  Google Scholar 

  78. Casey JR, Adlowitz DG, Pichichero ME. New patterns in the otopathogens causing acute otitis media six to eight years after introduction of pneumococcal conjugate vaccine. Pediatr Infect Dis J. 2010;29(4):304–9. doi:10.1097/INF.0b013e3181c1bc48.

    PubMed  Google Scholar 

  79. Dagan R, Givon-Lavi N, Leibovitz E, Raiz S, Greenberg D. Rapid reduction in the incidence of culture-positive non-susceptible Streptococcus pneumoniae (NSSP) otitis media (AOM) following introduction of pneumococcal conjugate vaccines (PCVs) in southern Israel. ICAAC G-1050. 2012.

  80. Hogberg L, Geli P, Ringberg H, Melander E, Lipsitch M, Ekdahl K. Age- and serogroup-related differences in observed durations of nasopharyngeal carriage of penicillin-resistant pneumococci. J Clin Microbiol. 2007;45(3):948–52. doi:10.1128/JCM.01913-06.

    Article  PubMed Central  PubMed  Google Scholar 

  81. Givon-Lavi N, Fraser D, Dagan R. Vaccination of day-care center attendees reduces carriage of Streptococcus pneumoniae among their younger siblings. Pediatr Infect Dis J. 2003;22(6):524–32. doi:10.1097/01.inf.0000069760.65826.f2.

    PubMed  Google Scholar 

  82. Malhotra-Kumar S, Lammens C, Coenen S, Van Herck K, Goossens H. Effect of azithromycin and clarithromycin therapy on pharyngeal carriage of macrolide-resistant streptococci in healthy volunteers: a randomised, double-blind, placebo-controlled study. Lancet. 2007;369(9560):482–90. doi:10.1016/S0140-6736(07)60235-9.

    Article  CAS  PubMed  Google Scholar 

  83. Couloigner V, Levy C, Francois M, Bidet P, Hausdorff WP, Pascal T, et al. Pathogens implicated in acute otitis media failures after 7-valent pneumococcal conjugate vaccine implementation in France: distribution, serotypes, and resistance levels. Pediatr Infect Dis J. 2012;31(2):154–8. doi:10.1097/INF.0b013e3182357c8d.

    Article  PubMed  Google Scholar 

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Acknowledgments

No funding was received for the preparation of this article.

Isabelle Hau has received support for travel and accommodation expenses to attend meetings from Sanofi Pasteur MSD, Pfizer, and Wyeth. Corinne Levy has received honoraria and payment for lectures, support for travel and accommodation expenses to attend meetings from Pfizer and Novartis. Laurence Caeymaex has no conflicts of interest that are directly relevant to the content of this article. Robert Cohen has received consulting fees, honoraria and payment for lectures, support for travel and accommodation expenses to attend meetings from Pfizer, GlaxoSmithKline, Novartis, and Sanofi Pasteur MSD.

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Hau, I., Levy, C., Caeymaex, L. et al. Impact of Pneumococcal Conjugate Vaccines on Microbial Epidemiology and Clinical Outcomes of Acute Otitis Media. Pediatr Drugs 16, 1–12 (2014). https://doi.org/10.1007/s40272-013-0044-2

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