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Prevalence of Pneumococcal and Hemophilus Influenza Type B Antibody Deficiency in Children With Persistent Ear, Nose,
Katherine Claire Babin1, Camille Martin1, Marlee Wadsworth2
1Department of Otolaryngology, University of Mississippi Medical Center, Jackson, MS, USA.
Insights
Pediatric patients with recurrent ear and sinus infections often have low antibody levels against Hib and Pneumococcus, suggesting a need for titer testing and potential booster vaccinations.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Otolaryngology
Background:
- Recurrent ear and sinus infections in children, such as otitis media and sinusitis, can significantly impact quality of life.
- Surgical interventions like ear tube placement and adenoidectomy are common management strategies.
- The role of underlying antibody deficiencies in treatment failure is an area of ongoing investigation.
Purpose of the Study:
- To determine the prevalence of antibody deficiencies against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Pneumococcus) in pediatric patients with persistent or recurrent ear, nose, and throat (ENT) infections.
- To assess antibody levels following common ENT surgical procedures.
Main Methods:
- A retrospective chart review was conducted at a tertiary referral hospital.
- Data from 43 pediatric patients who underwent ear tube placement or adenoidectomy with available vaccination titers were analyzed.
- Prevalence of Hib and Pneumococcal antibody deficiencies was calculated, with statistical analysis performed using appropriate tests.
Main Results:
- Over half (55%) of the patients had indeterminate or non-protective titers against Hib.
- 43% of patients exhibited non-protective titers against Pneumococcus.
- Children with recurrent ENT infections were found to be significantly more likely (11 times for Hib, 14 times for Pneumococcus) to have inadequate antibody levels compared to expected vaccination response rates.
Conclusions:
- A significant proportion of pediatric patients with recurrent ENT infections may have suboptimal antibody responses to Hib and Pneumococcal vaccines.
- Testing antibody titers in this population, even after surgical management, is warranted.
- Booster vaccinations could be a potential therapeutic strategy for children with recurrent ENT infections and identified antibody deficiencies.
Objective:
The primary objective of this study is to determine the prevalence of Hib and Pneumococcal antibody deficiencies in pediatric patients with persistent or recurrent ENT infections, namely recurrent otitis media and recurrent sinusitis, following ear tube placement or adenoidectomy.
Study Design:
This is an IRB approved, single institution, retrospective chart review using the electronic medical record at University of Mississippi Medical Center from January 2013 to December 2023.
Setting:
University of Mississippi Medical Center, a tertiary referral hospital.
Methods:
This study included 43 patients who had undergone either ear tube placement or adenoidectomy with a history of PCV and Hib titers data. Demographic data was obtained and complete vaccination records were confirmed. Prevalence of PCV and Hib titer deficiency was calculated, and statistical analysis was performed using Chi-square tests, Fischer exact test or independent t-test, depending on the variables.
Results:
More than half (55%) of these patients were found to be indeterminate or have non-protective titers against Hemophilus influenzae type B, and 43% had titers considered non-protective against Pneumococcus. Given vaccination response rates are approximately 95% for the Hib vaccine and 97% to 100% for Prevnar vaccine, this demonstrates that children with recurrent ENT infections are approximately 11 times more likely to have indeterminate or non-protective titers to Hib and 14 times more likely to have non-protective titers to Pneumococcus.
Conclusion:
This study highlights the potential role of testing these titers in pediatric patients with recurrent ear and sinus infections despite surgical management, and sheds light on the potential role of booster vaccinations in this population.
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