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Acute otitis media caused by Streptococcus pneumoniae serotype 19A ST320 clone: epidemiological and clinical

Hsin Chi1, Nan-Chang Chiu2, Fu-Yuan Huang3

  • 1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|January 15, 2017
PubMed
Abstract

Insights

Streptococcus pneumoniae 19A ST320 is a common cause of acute otitis media (AOM) in young children in Taiwan. Vaccination against Serotype 19A in infancy is recommended to prevent AOM episodes.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Streptococcus pneumoniae serotype 19A ST320 is a highly multiresistant and virulent clone.
  • This clone has emerged as a common cause of acute otitis media (AOM) in children.

Purpose of the Study:

  • To investigate the prevalence and characteristics of Streptococcus pneumoniae serotypes causing AOM in children.
  • To identify the most frequent serotype and sequence type (ST) responsible for AOM.
  • To analyze clinical features and antibiotic resistance patterns associated with specific serotypes.

Main Methods:

  • Prospective enrollment of pediatric patients (0-18 years) with AOM at Mackay Memorial Hospital, Taipei, Taiwan.
  • Collection and culture of middle-ear fluid specimens.
  • Serotyping, antibiotic-resistance profiling, and multilocus sequence typing of S. pneumoniae isolates.

Main Results:

  • Pneumococcal AOM occurred in 24.8% of episodes. Serotype 19A was the most common (64.4%), with 19A ST320 being the most frequent isolate (58.8%).
  • Children with 19A ST320-associated AOM were younger and had a higher rate of spontaneous tympanic membrane rupture.
  • Serotype 19A ST320 caused 90% of AOM in infants ≤12 months and showed higher resistance to penicillin, amoxicillin, and trimethoprim/sulfamethoxazole.

Conclusions:

  • Serotype 19A ST320 is a significant pathogen in pediatric AOM in Taiwan.
  • Early infant vaccination with pneumococcal conjugate vaccines effective against Serotype 19A is crucial.
  • Vaccination can prevent initial and recurrent episodes of AOM in children.
Keywords:
Serotype 19AStreptococcus pneumoniaeacute otitis media

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