Related Experiment Video
Updated: Jun 24, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Anticipated Effects of Higher-valency Pneumococcal Conjugate Vaccines on Colonization and Acute Otitis Media
Ravinder Kaur1, Steven Schulz1, Andrew Sherman1
1From the Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York.
Background:
Bacterial etiologies of acute otitis media (AOM) have shifted from the introduction of pneumococcal conjugate vaccines (PCVs), antibiotic selection and competition among species. We characterized Streptococcus pneumoniae ( Spn ), Haemophilus influenzae ( Hflu ) and Moraxella catarrhalis ( Mcat ) in the nasopharynx during well-child healthy visits and at the onset of AOM, and in middle ear fluid (MEF) of children with AOM to assess anticipated effects of higher-valency PCVs (PCV15 and PCV20).
Methods:
From September 2021 to September 2023, we conducted a prospective longitudinal cohort study of PCV13 immunized children 6-36 months old. MEF was collected via tympanocentesis. Serotyping and antibiotic susceptibility testing were performed on Spn , Hflu and Mcat isolates.
Results:
We obtained 825 nasopharyngeal and 216 MEF samples from 301 children. The order of frequency of nasopharyngeal colonization was Mcat , Spn and Hflu ; Hflu was the predominant otopathogen in MEF. Among Spn isolates, non-PCV15, non-PCV20 serotypes predominated in the nasopharynx and in MEF; the most frequent serotype was 35B. Among MEF samples, 30% of Spn isolates were amoxicillin nonsusceptible; 23% of Hflu isolates and 100% of Mcat isolates were β-lactamase-producing.
Conclusion:
The majority of Spn isolates among young children were non-PCV15, non-PCV20 serotypes, especially serotype 35B; therefore, the impact of higher-valency PCVs in reducing pneumococcal colonization or AOM is expected to be limited. Hflu continues to be the most frequent AOM pathogen. Antibiotic susceptibility data suggest a high dose of amoxicillin/clavulanate or alternative drugs that are effective against contemporary mix of otopathogens could be considered for optimal empiric selection to provide the best efficacy.
Insights
Higher-valency pneumococcal conjugate vaccines (PCVs) may have limited impact on acute otitis media (AOM) as non-PCV15/20 serotypes, like 35B, predominated. Haemophilus influenzae remains a common AOM pathogen, necessitating updated antibiotic strategies.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Vaccinology
Background:
- Bacterial etiologies of acute otitis media (AOM) have evolved due to pneumococcal conjugate vaccines (PCVs) and antibiotic use.
- Characterizing key otopathogens like Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hflu), and Moraxella catarrhalis (Mcat) is crucial for understanding AOM shifts.
Purpose of the Study:
- To characterize Spn, Hflu, and Mcat in the nasopharynx and middle ear fluid (MEF) of children.
- To assess the potential impact of higher-valency PCVs (PCV15 and PCV20) on AOM bacterial profiles.
Main Methods:
- Prospective longitudinal cohort study of PCV13-immunized children aged 6-36 months (September 2021-September 2023).
- Collection of nasopharyngeal and MEF samples via tympanocentesis.
- Serotyping and antibiotic susceptibility testing of Spn, Hflu, and Mcat isolates.
Main Results:
- Hflu was the predominant otopathogen in MEF, while Mcat and Spn were more frequent in nasopharyngeal colonization.
- Non-PCV15 and non-PCV20 Spn serotypes, particularly serotype 35B, were prevalent in both nasopharyngeal and MEF isolates.
- Significant antibiotic resistance was observed: 30% of Spn, 23% of Hflu were amoxicillin non-susceptible, and 100% of Mcat isolates were beta-lactamase-producing.
Conclusions:
- Higher-valency PCVs (PCV15, PCV20) may have a limited effect on reducing pneumococcal colonization and AOM due to the predominance of non-vaccine serotypes.
- H. influenzae remains a primary pathogen in AOM.
- Current antibiotic resistance patterns suggest a need for high-dose amoxicillin/clavulanate or alternative empiric treatments for optimal AOM management.
More Related Videos
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:51Vaccinations
01:29Pneumonia II: Pathophysiology
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...