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What effect has pneumococcal vaccination had on acute mastoiditis?

M Daniel1, S Gautam, T A Scrivener

  • 1Department of Paediatric Otorhinolaryngology Head and Neck Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. matija.daniel@nottingham.ac.uk

The Journal of Laryngology and Otology
|November 29, 2012
PubMed
Abstract

Insights

Pneumococcal vaccination initially reduced acute mastoiditis and complications. However, mastoiditis incidence and severity returned to pre-vaccination levels shortly after vaccine introduction.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Otolaryngology

Background:

  • Streptococcus pneumoniae is a primary cause of acute mastoiditis.
  • The introduction of pneumococcal vaccination in 2005 may impact mastoiditis trends.
  • This study investigates changes in mastoiditis incidence and severity over an 11-year period.

Purpose of the Study:

  • To assess the incidence, severity, and microbiology of acute mastoiditis.
  • To compare trends before, during, and after pneumococcal vaccine introduction.
  • To evaluate the impact of vaccination on mastoiditis-related complications and treatment.

Main Methods:

  • Retrospective review of pediatric acute mastoiditis cases from 2000-2010.
  • Comparison of three periods: pre-vaccination (2000-2004), peri-vaccination (2005-2007), and post-vaccination (2008-2010).
  • Analysis of case load, microbiology, clinical severity, complications, and treatment duration.

Main Results:

  • Annual mastoiditis cases initially decreased post-vaccination but then returned to pre-vaccination levels.
  • Pneumococcal isolates dropped significantly in the peri-vaccination period but increased afterward.
  • Incidence of intracranial complications decreased initially but rose again post-vaccination.

Conclusions:

  • Pneumococcal vaccination temporarily reduced mastoiditis admissions and complications.
  • Mastoiditis incidence and severity rebounded to pre-vaccination levels after vaccine introduction.
  • Ongoing surveillance is crucial to monitor long-term effects of vaccination on mastoiditis.

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