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Serotype distribution in pneumococcal acute otitis media with ruptured tympanic membrane or sepsis in Germany

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An Erratum to this article was published on 16 July 2010

Abstract

This retrospective analysis examined the pneumococcal serotype distribution of acute otitis media in Germany from 1995 to 2007. Data from the German National Reference Centre for Streptococci included 512 cases of pneumococcal otitis media in children and adults. Infections were mainly seen in children aged <5 years, who represented 67.0% of all reported cases. Most isolates (86.7%) were from spontaneous ruptures of the tympanum; 11.1% of the isolates were from otogenic sepsis or meningitis. Serotype 19F was the leading serotype (21.5%); serotype 3 (13.9%) was also often encountered. In children aged <5 years, the 7-valent, 10-valent, and 13-valent pneumococcal conjugate vaccines covered 54.3%, 60.2%, and 84.6% of the serotypes, respectively. Reduced penicillin susceptibility (minimum inhibitory concentration ≥0.1 mg/l) was seen in 11.0% of strains; 22.4% of strains were resistant to macrolides. Although based on a very limited selection of acute otitis media isolates, this analysis provides an estimate of the pneumococcal serotypes responsible for otitis media in Germany and underscores the need for future prospective studies.

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References

  1. Fletcher MA, Fritzell B (2007) Brief review of the clinical effectiveness of PREVENAR® against otitis media. Vaccine 25:2507–2512

    Article  CAS  PubMed  Google Scholar 

  2. Palmu AAI, Herva E, Savolainen H, Karma P, Makela PH, Kilpi TM (2004) Association of clinical signs and symptoms with bacterial findings in acute otitis media. Clin Infect Dis 38:234–242

    Article  PubMed  Google Scholar 

  3. Block SL, Hedrick J, Harrison CJ, Tyler R, Smith A, Findlay R, Keegan E (2002) Pneumococcal serotypes from acute otitis media in rural Kentucky. Pediatr Infect Dis J 21:859–865

    Article  PubMed  Google Scholar 

  4. Butler JC, Breiman RF, Lipman HB, Hofmann J, Facklam RR (1995) Serotype distribution of Streptococcus pneumoniae infections among preschool children in the United States, 1978–1994: implications for development of a conjugate vaccine. J Infect Dis 171:885–889

    CAS  PubMed  Google Scholar 

  5. Black S, Shinefield H, Fireman B, Lewis E, Ray P, Hansen JR, Elvin L, Ensor KM, Hackell J, Siber G, Malinoski F, Madore D, Chang I, Kohberger R, Watson W, Austrian R, Edwards K (2000) Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group. Pediatr Infect Dis J 19:187–195

    Article  CAS  PubMed  Google Scholar 

  6. Eskola J, Kilpi T, Palmu A, Jokinen J, Haapakoski J, Herva E, Takala A, Kayhty H, Karma P, Kohberger R, Siber G, Makela PH (2001) Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 344:403–409

    Article  CAS  PubMed  Google Scholar 

  7. Fireman B, Black SB, Shinefield HR, Lee J, Lewis E, Ray P (2003) Impact of the pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J 22:10–16

    Article  PubMed  Google Scholar 

  8. Palmu AAI, Verho J, Jokinen J, Karma P, Kilpi TM (2004) The seven-valent pneumococcal conjugate vaccine reduces tympanostomy tube placement in children. Pediatr Infect Dis J 23:732–738

    Article  PubMed  Google Scholar 

  9. Shouval DS, Greenberg D, Givon-Lavi N, Porat N, Dagan R (2009) Serotype coverage of invasive and mucosal pneumococcal disease in Israeli children younger than 3 years by various pneumococcal conjugate vaccines. Pediatr Infect Dis J 28:277–282

    Article  PubMed  Google Scholar 

  10. Rodgers GL, Arguedas A, Cohen R, Dagan R (2009) Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: potential implications for pneumococcal conjugate vaccines. Vaccine 27:3802–3810

    Article  CAS  PubMed  Google Scholar 

  11. Block SL, Hedrick J, Harrison CJ, Tyler R, Smith A, Findlay R, Keegan E (2004) Community-wide vaccination with the heptavalent pneumococcal conjugate significantly alters the microbiology of acute otitis media. Pediatr Infect Dis J 23:829–833

    Article  PubMed  Google Scholar 

  12. Casey JR, Pichichero ME (2004) Changes in frequency and pathogens causing acute otitis media in 1995–2003. Pediatr Infect Dis J 23:824–828

    Article  PubMed  Google Scholar 

  13. McEllistrem MC, Adams J, Mason EO, Wald ER (2003) Epidemiology of acute otitis media caused by Streptococcus pneumoniae before and after licensure of the 7-valent pneumococcal protein conjugate vaccine. J Infect Dis 188:1679–1684

    Article  CAS  PubMed  Google Scholar 

  14. Zhou F, Shefer A, Kong Y, Nuorti JP (2008) Trends in acute otitis media-related health care utilization by privately insured young children in the United States, 1997–2004. Pediatrics 121:253–260

    Article  PubMed  Google Scholar 

  15. Claes C, Reinert RR, Vauth C, Greiner W (2008) Health Technology Assessment. Heptavalenter Pneumokokkenkonjugat-Impfstoff (PCV7). http://portal.dimdi.de/de/hta/hta_berichte/hta202_bericht_de.pdf. Accessed 26 April 2010

  16. Ziebold C, von Kries R, Siedler A, Schmitt HJ (2000) Epidemiology of pneumococcal disease in children in Germany. Acta Paediatr Suppl 435:17–21

    Article  Google Scholar 

  17. Reinert RR, Simic S, Al-Lahham A, Reinert S, Lemperle M, Lütticken R (2001) Antimicrobial resistance of Streptococcus pneumoniae recovered from outpatients with respiratory tract infections in Germany from 1998 to 1999: results of a national surveillance study. J Clin Microbiol 39:1187–1189

    Article  CAS  PubMed  Google Scholar 

  18. Reinert RR, van der Linden M, Seegmuller I, Al-Lahham A, Siedler A, Weissmann B, Toschke AM, von Kries R (2007) Molecular epidemiology of penicillin-non-susceptible Streptococcus pneumoniae isolates from children with invasive pneumococcal disease in Germany. Clin Microbiol Infect 13:363–368

    Article  CAS  PubMed  Google Scholar 

  19. Siedler A, Reinert RR, Toschke M, Al-Lahham A, von Kries R (2005) Regional differences in the epidemiology of invasive pneumococcal disease in toddlers in Germany. Pediatr Infect Dis J 24:1114–1115

    Article  PubMed  Google Scholar 

  20. von Kries R, Hermann M, Al-Lahham A, Siedler A, Reinert RR (2002) Will the 7-valent pneumococcal vaccine have a similar impact on all invasive pneumococcal infections in children in Germany as in the Kaiser Permanente Trial? Eur J Pediatr 161:S140–S143

    Article  Google Scholar 

  21. von Kries R, Hermann M, Hachmeister A, Siedler A, Schmitt HJ, Al-Lahham A, Reinert RR (2002) Prediction of the potential benefit of different pneumococcal conjugate vaccines on invasive pneumococcal disease in German children. Pediatr Infect Dis J 21:1017–1023

    Article  Google Scholar 

  22. von Kries R, Siedler A, Schmitt HJ, Reinert RR (2000) Proportion of invasive pneumococcal infections in German children preventable by pneumococcal conjugate vaccines. Clin Infect Dis 31:482–487

    Article  Google Scholar 

  23. Reinert RR, Haupts S, van der Linden M, Heeg C, Cil MY, Al-Lahham A, Fedson DS (2005) Invasive pneumococcal disease in adults in North-Rhine Westphalia, Germany, 2001–2003. Clin Microbiol Infect 11:985–991

    Article  CAS  PubMed  Google Scholar 

  24. Clinical and Laboratory Standards Institute (2006) Performance standards for antimicrobial disk susceptibility tests; approved standard—9th edition. CLSI, Wayne, PA, USA

    Google Scholar 

  25. Whitney CG, Pilishvili T, Farley MM, Schaffner W, Craig AS, Lynfield R, Nyquist A-C, Gershman KA, Vazquez M, Bennett NM, Reingold A, Thomas A, Glode MP, Zell ER, Jorgensen JH, Beall B, Schuchat A (2006) Effectiveness of seven-valent pneumoccoccal conjugate vaccine against invasive pneumococcal disease: a matched case-control study. Lancet 368:1495–1502

    Article  CAS  PubMed  Google Scholar 

  26. Vesikari T, Wysocki J, Chevallier B, Karvonen A, Czajka H, Arsene J-P, Lommel P, Dieussaert I, Schuerman L (2009) Immunogenicity of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) compared to the licensed 7vCRM vaccine. Pediatr Infect Dis J 28:S66–S76

    Article  PubMed  Google Scholar 

  27. Prymula R, Peeters P, Chrobok V, Kriz P, Novakova E, Kaliskova E, Kohl I, Lommel P, Poolman J, Prieels JP, Schuerman L (2006) 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 367:740–748

    Article  CAS  PubMed  Google Scholar 

  28. Hausdorff WP, Yothers G, Dagan R, Kilpi T, Pelton SI, Cohen R, Jacobs MR, Kaplan SL, Levy C, Lopez EL, Mason EO Jr, Syriopoulou V, Wynne B, Bryant J (2002) Multinational study of pneumococcal serotypes causing acute otitis media in children. Pediatr Infect Dis J 21:1008–1016

    Article  PubMed  Google Scholar 

  29. Vergison A, Reinert RR (2007) Streptococcus pneumoniae incidence in Western Europe. Lancet Infect Dis 7:240–242

    Article  PubMed  Google Scholar 

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Acknowledgements

Medical writing support for this manuscript was provided by Prasad Kulkarni of Excerpta Medica (Bridgewater, NJ), and was funded by Wyeth, which was acquired by Pfizer Inc in October 2009.

Conflicts of interest

Dr Reinert is an employee of Pfizer Inc. Dr van der Linden has been a member of advisory boards for Wyeth and GlaxoSmithKline, and has received invitations to scientific conferences from Wyeth and GlaxoSmithKline.

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Authors and Affiliations

  1. Department of Medical Microbiology, National Reference Centre for Streptococci, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany

    M. van der Linden

  2. Pfizer Inc. (formerly Wyeth Vaccines Research), Paris La Défense, Paris, France

    R. R. Reinert

Authors
  1. M. van der Linden
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  2. R. R. Reinert
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Correspondence to M. van der Linden.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s10096-010-1012-1

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van der Linden, M., Reinert, R.R. Serotype distribution in pneumococcal acute otitis media with ruptured tympanic membrane or sepsis in Germany. Eur J Clin Microbiol Infect Dis 29, 749–754 (2010). https://doi.org/10.1007/s10096-010-0945-8

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  • DOI: https://doi.org/10.1007/s10096-010-0945-8

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