scholarly journals The Effect of the 10-Valent Pneumococcal NontypeableHaemophilus influenzaeProtein D Conjugate Vaccine onH. influenzaein Healthy Carriers and Middle Ear Infections in Iceland

2019 ◽  
Vol 57 (7) ◽  
Author(s):  
Hildigunnur Sveinsdóttir ◽  
Jana Birta Björnsdóttir ◽  
Helga Erlendsdóttir ◽  
Martha Á. Hjálmarsdóttir ◽  
Birgir Hrafnkelsson ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Annual Number ◽  
Healthy Children ◽  
Carriage Rate ◽  
Content Type ◽  
Ear Infections ◽  
Culture Positive ◽  
Healthy Carriers

ABSTRACTVaccinations with the 10-valent pneumococcal conjugated vaccine (PHiD-CV) started in Iceland in 2011. Protein D (PD) fromH. influenzae, which is coded for by thehpdgene, is used as a conjugate in the vaccine and may provide protection against PD-positiveH. influenzae. We aimed to evaluate the effect of PHiD-CV vaccination onH. influenzaein children, both in carriage and in acute otitis media (AOM).H. influenzaewas isolated from nasopharyngeal swabs collected from healthy children attending 15 day care centers in 2009 and from 2012 to 2017 and from middle ear (ME) samples from children with AOM collected from 2012 to 2017. All isolates were identified using PCR for thehpdandfucKgenes. Of the 3,600 samples collected from healthy children, 2,465 were culture positive forH. influenzae(68.5% carriage rate); of these, 151 (6.1%) containedhpd-negative isolates. Of the 2,847 ME samples collected, 889 (31.2%) were culture positive forH. influenzae; of these, 71 (8.0%) werehpdnegative. Despite the same practice throughout the study, the annual number of ME samples reduced from 660 in 2012 to 330 in 2017. The proportions ofhpd-negative isolates in unvaccinated versus vaccinated children were 5.6% and 7.0%, respectively, in healthy carriers, and 5.4% and 7.8%, respectively, in ME samples. The proportion ofhpd-negative isolates increased with time in ME samples but not in healthy carriers. The number of ME samples from children with AOM decreased. The PHiD-CV had no effect on the proportion of thehpdgene inH. influenzaefrom carriage, but there was an increase inhpd-negativeH. influenzaein otitis media. The proportions ofhpd-negative isolates remained similar in vaccinated and unvaccinated children.

scholarly journals Effect of Vaccination on Pneumococci Isolated from the Nasopharynx of Healthy Children and the Middle Ear of Children with Otitis Media in Iceland

2018 ◽  
Vol 56 (12) ◽  
Author(s):  
Sigríður J. Quirk ◽  
Gunnsteinn Haraldsson ◽  
Helga Erlendsdóttir ◽  
Martha Á. Hjálmarsdóttir ◽  
Andries J. van Tonder ◽  
...  
Keyword(s):  
Otitis Media ◽  
Antimicrobial Susceptibility ◽  
Acute Otitis Media ◽  
Significant Shift ◽  
Healthy Children ◽  
Nasopharyngeal Carriage ◽  
Carriage Rate ◽  
Genetic Lineages ◽  
Vaccine Type ◽  
The Impact

ABSTRACTVaccination with pneumococcal conjugate vaccines (PCVs) disrupts the pneumococcal population. Our aim was to determine the impact of the 10-valent PCV on the serotypes, genetic lineages, and antimicrobial susceptibility of pneumococci isolated from children in Iceland. Pneumococci were collected between 2009 and 2017 from the nasopharynges of healthy children attending 15 day care centers and from the middle ears (MEs) of children with acute otitis media from the greater Reykjavik capital area. Isolates were serotyped and tested for antimicrobial susceptibility. Whole-genome sequencing (WGS) was performed on alternate isolates from 2009 to 2014, and serotypes and multilocus sequence types (STs) were extracted from the WGS data. Two study periods were defined: 2009 to 2011 (PreVac) and 2012 to 2017 (PostVac). The overall nasopharyngeal carriage rate was similar between the two periods (67.3% PreVac and 61.5% PostVac,P= 0.090). Vaccine-type (VT) pneumococci decreased and nonvaccine-type (NVT) pneumococci (serotypes 6C, 15A, 15B/C, 21, 22F, 23A, 23B, 35F, and 35B) significantly increased in different age strata post-PCV introduction. The total number of pneumococci recovered from ME samples significantly decreased as did the proportion that were VTs, although NVT pneumococci (6C, 15B/C, 23A, and 23B) increased significantly. Most serotype 6C pneumococci were multidrug resistant (MDR). Serotype 19F was the predominant serotype associated with MEs, and it significantly decreased post-PCV introduction: these isolates were predominantly MDR and of the Taiwan19F-14 PMEN lineage. Overall, the nasopharyngeal carriage rate remained constant and the number of ME-associated pneumococci decreased significantly post-PCV introduction; however, there was a concomitant and statistically significant shift from VTs to NVTs in both collections of pneumococci.

scholarly journals Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

2016 ◽  
Vol 54 (9) ◽  
pp. 2373-2379 ◽  
Author(s):  
Saara Sillanpää ◽  
Sami Oikarinen ◽  
Markku Sipilä ◽  
Lenka Kramna ◽  
Markus Rautiainen ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Moraxella Catarrhalis ◽  
Acute Otitis Media ◽  
Pcr Analysis ◽  
Considerable Proportion ◽  
Bacterial Dna ◽  
Content Type ◽  
Conventional Culture

According to studies based on bacterial cultures of middle ear fluids,Streptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalishave been the most common pathogens in acute otitis media. However, bacterial culture can be affected by reduced viability or suboptimal growth of bacteria. PCR detects bacterial DNA from samples with greater sensitivity than culture. In the present study, we analyzed the middle ear pathogens with both conventional culture and semiquantitative real-time PCR in 90 middle ear fluid samples obtained from children aged 5 to 42 months during acute otitis media episodes. Samples were tested for the presence ofS. pneumoniae,H. influenzae,M. catarrhalis,Alloiococcusotitidis,Staphylococcus aureus, andPseudomonas aeruginosa. One or more bacterial pathogens were detected in 42 (47%) samples with culture and in 69 (77%) samples with PCR. According to PCR analysis,M. catarrhalisresults were positive in 42 (47%) samples,H. influenzaein 30 (33%),S. pneumoniaein 27 (30%),A. otitidisin 6 (6.7%),S. aureusin 5 (5.6%), andP. aeruginosain 1 (1.1%). Multibacterial etiology was seen in 34 (38%) samples, andM. catarrhaliswas detected in most (85%) of those cases. Fifteen signals forM. catarrhaliswere strong, suggesting a highly probable etiological role of the pathogen. In conclusion, even thoughM. catarrhalisis often a part of mixed flora in acute otitis media, a considerable proportion of cases may be primarily attributable to this pathogen.

scholarly journals Upper Respiratory Tract Microbial Communities, Acute Otitis Media Pathogens, and Antibiotic Use in Healthy and Sick Children

2012 ◽  
Vol 78 (17) ◽  
pp. 6262-6270 ◽  
Author(s):  
Melinda M. Pettigrew ◽  
Alison S. Laufer ◽  
Janneane F. Gent ◽  
Yong Kong ◽  
Kristopher P. Fennie ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Microbial Communities ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Antibiotic Use ◽  
Healthy Children ◽  
Upper Respiratory Tract ◽  
Content Type ◽  
The Past ◽  
Upper Respiratory

ABSTRACTThe composition of the upper respiratory tract microbial community may influence the risk for colonization by the acute otitis media (AOM) pathogensStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalis. We used culture-independent methods to describe upper respiratory tract microbial communities in healthy children and children with upper respiratory tract infection with and without concurrent AOM. Nasal swabs and data were collected in a cross-sectional study of 240 children between 6 months and 3 years of age. Swabs were cultured forS. pneumoniae, and real-time PCR was used to identifyS. pneumoniae,H. influenzae, andM. catarrhalis. The V1-V2 16S rRNA gene regions were sequenced using 454 pyrosequencing. Microbial communities were described using a taxon-based approach. Colonization byS. pneumoniae,H. influenzae, andM. catarrhaliswas associated with lower levels of diversity in upper respiratory tract flora. We identified commensal taxa that were negatively associated with colonization by each AOM bacterial pathogen and with AOM. The balance of these relationships differed according to the colonizing AOM pathogen and history of antibiotic use. Children with antibiotic use in the past 6 months and a greater abundance of taxa, includingLactococcusandPropionibacterium, were less likely to have AOM than healthy children (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.25 to 0.85). Children with no antibiotic use in the past 6 months, a low abundance ofStreptococcusandHaemophilus, and a high abundance ofCorynebacteriumandDolosigranulumwere less likely to have AOM (OR, 0.51; 95% CI, 0.31 to 0.83). An increased understanding of polymicrobial interactions will facilitate the development of effective AOM prevention strategies.

A new technique (the NOW test) for the detection of Streptococcus pneumoniae in the effusions of otitis media

2002 ◽  
Vol 116 (7) ◽  
pp. 499-501 ◽  
Author(s):  
Howard Faden ◽  
Christopher Poje ◽  
Michael Pizzuto ◽  
Mark Nagy ◽  
Linda Brodsky
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Urinary Antigen Test ◽  
Pneumococcal Antigen ◽  
A New Technique ◽  
Culture Positive ◽  
Culture Negative

The presence of Streptococcus pneumoniae in chronic otitis media was determined with a new antigen detection kit, the NOW test. The NOW test was originally designed as a urinary antigen test but was adapted to middle-ear effusions for the present study. Middle-ear effusions from 52 children were studied. Streptococcus pneumoniae was cultured from 10 per cent of the effusions. The NOW test was positive in 23 per cent of the effusions, 80 per cent of culture positive and 17 per cent of culture negative effusions. The NOW test proved to be rapid, simple, reliable and relatively inexpensive for the detection of pneumococcal antigen in the middle-ear effusions. This test may prove valuable for the management of children with acute otitis media who undergo tympanocentesis.

scholarly journals Has Otitis Media Disappeared during COVID-19 Pandemic? A Fortuitus Effect of Domestic Confinement

2021 ◽  
Vol 10 (13) ◽  
pp. 2851
Author(s):  
Sara Torretta ◽  
Barbara Cantoni ◽  
Giuseppe Bertolozzi ◽  
Pasquale Capaccio ◽  
Gregorio Paolo Milani ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Patient Flow ◽  
Acute Otitis Media ◽  
Pediatric Emergency ◽  
P Value ◽  
Period 2 ◽  
Middle Ear Infection ◽  
Significant Difference ◽  
Ear Infections

Background: To measure patient flow at our Pediatric Emergency Department (PED) during the Italian lockdown, with particular care in terms of otolaryngological (ENT)-related diagnoses. Methods: A retrospective evaluation of electronic charts of children admitted to our PED in the City Center of Milan (Italy) for any disease. The outcome was to compare distribution of diagnoses performed at our PED during 21 February–3 May 2019 (period 1) to 21 February–3 May 2020 (period 2). Results: A total of 4538 children were evaluated during period 1 compared to 1310 during period 2. A statistically significant overall effect on diagnosis between the study periods was attested (p-value < 0.001; pseudoR2 = 0.010), ENT-related diagnoses being more frequently documented in period 1 (80.4% vs. 19.5%; p-value < 0.001), as well as those related to middle ear infections (92.8% vs. 7.2%; p-value < 0.001). Non-complicated acute otitis media more frequently occurred in period 1 (92.0% vs. 8.0%; p-value < 0.001); no significant difference in the number of complicated middle ear infections occurred (95.8% vs. 4.2%). Conclusions: The exceptional circumstances of the Italian lockdown resulted in a significant decrease in patients’ attendance to our PED, especially when considering diagnoses related to any ENT disorder, middle ear disease, and non-complicated middle ear infection.

scholarly journals Comparative Profile of Heme Acquisition Genes in Disease-Causing and Colonizing Nontypeable Haemophilus influenzae and Haemophilus haemolyticus

2015 ◽  
Vol 53 (7) ◽  
pp. 2132-2137 ◽  
Author(s):  
Nurul I. Hariadi ◽  
Lixin Zhang ◽  
Mayuri Patel ◽  
Sara A. Sandstedt ◽  
Gregg S. Davis ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Healthy Children ◽  
Nontypeable Haemophilus Influenzae ◽  
Closely Related Species ◽  
Content Type ◽  
Nutritional Immunity ◽  
Heme Acquisition ◽  
Tract Infections

NontypeableHaemophilus influenzae(NTHI) are Gram-negative bacteria that colonize the human pharynx and can cause respiratory tract infections, such as acute otitis media (AOM). Since NTHI require iron from their hosts for aerobic growth, the heme acquisition genes may play a significant role in avoiding host nutritional immunity and determining virulence. Therefore, we employed a hybridization-based technique to compare the prevalence of five heme acquisition genes (hxuA,hxuB,hxuC,hemR, andhup) between 514 middle ear strains from children with AOM and 235 throat strains from healthy children. We also investigated their prevalences in 148Haemophilus haemolyticusstrains, a closely related species that colonizes the human pharynx and is considered to be nonpathogenic. Four out of five genes (hxuA,hxuB,hxuC, andhemR) were significantly more prevalent in the middle ear strains (96%, 100%, 100%, and 97%, respectively) than in throat strains (80%, 92%, 93%, and 85%, respectively) of NTHI, suggesting that strains possessing these genes have a virulence advantage over those lacking them. All five genes were dramatically more prevalent in NTHI strains than inH. haemolyticus, with 91% versus 9%hxuA, 98% versus 11%hxuB, 98% versus 11%hxuC, 93% versus 20%hemR, and 97% versus 34%hup, supporting their potential role in virulence and highlighting their possibility to serve as biomarkers to distinguishH. influenzaefromH. haemolyticus. In summary, this study demonstrates that heme acquisition genes are more prevalent in disease-causing NTHI strains isolated from the middle ear than in colonizing NTHI strains andH. haemolyticusisolated from the pharynx.

scholarly journals Comparing Watchful Waiting Approach vs. Antibiotic Therapy in Children with Nonsevere Acute Otitis Media: A Randomized Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Leila Shahbaznejad ◽  
Ensieh Talaei ◽  
Fatemeh Hosseinzadeh ◽  
Baraneh Masoumi ◽  
Shaghayegh Rezai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Otitis Media ◽  
Middle Ear ◽  
Watchful Waiting ◽  
Acute Otitis Media ◽  
Control Group ◽  
Healthy Children ◽  
Middle Ear Effusion ◽  
Ear Effusion

Objective. To compare both approaches for the treatment of nonsevere acute otitis media (AOM) in Iran. Methods. This randomized clinical trial was performed at a pediatric infectious diseases clinic in Buali tertiary hospital in Sari, north of Iran, from 2016 to 2018. All participants in this study were previously healthy children with AOM diagnosis, who were 6 months to 6 years old. The patients were randomly assigned into two groups: the intervention (80 mg/kg/day amoxicillin for 7-10 days) and the control group (watchful waiting approach). AOM recovery and adverse drug reactions were evaluated after 72 hours, and the patients were followed for the frequency of AOM and middle ear effusion 1 and 3 months’ postintervention. Results. A total of 396 children have participated in this study. AOM recovery was significantly different in the two groups (73% vs. 44% in the intervention and control groups, respectively). Recurrence of AOM and middle ear effusion (MEE) persistence, one month following the intervention, have not shown any significant differences between the two groups. However, the AOM recurrence between 1 and 3 months was more frequent in the control group. The frequency of diarrhea was also higher in the intervention group compared to the control but no significant difference was found between the two groups regarding vomiting and skin rash. Conclusion. The faster recovery from AOM is achieved when an antibiotic treatment regimen is applied, although the risk of potential side effects should be considered.

scholarly journals Next-Generation Sequencing Combined with Specific PCR Assays To Determine the Bacterial 16S rRNA Gene Profiles of Middle Ear Fluid Collected from Children with Acute Otitis Media

mSphere ◽  
2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Saara Sillanpää ◽  
Lenka Kramna ◽  
Sami Oikarinen ◽  
Markku Sipilä ◽  
Markus Rautiainen ◽  
...  
Keyword(s):  
16S Rrna ◽  
16S Rrna Gene ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Rrna Gene ◽  
Content Type ◽  
Specific Pcr ◽  
Pcr Assays ◽  
Low Volume

ABSTRACT Although S. pneumoniae, H. influenzae, and M. catarrhalis have been long established as the most important pathogens in acute otitis media using culture and specific PCR assays, the knowledge of their mutual quantitative relations and possible roles of other bacteria is incomplete. The advent of unbiased bacteriome 16S rRNA gene profiling has allowed the detection of nearly all bacteria present in the sample, and it helps in depicting their mutual quantitative ratios. Due to the difficulties in performing mass sequencing in low-volume samples, only a few bacteriome-profiling studies of otitis media have been published, all limited to cases of chronic otitis media. Here, we present a study on samples obtained from young children with acute otitis media, successfully using a strategy of nested PCR coupled with mass sequencing, and demonstrate that the method can confer quantitative information hardly obtainable by other methods. The aim of the study was to analyze the bacteriome of acute otitis media with a novel modification of next-generation sequencing techniques. Outpatient children with acute otitis media were enrolled in the study, and middle ear fluids were collected during 90 episodes from 79 subjects aged 5 to 42 months (median age, 19 months). The bacteriome profiles of middle ear fluid samples were determined by a nested-PCR amplification of the 16S rRNA gene (V4 region), followed by mass sequencing. The profiling results were compared to the results of specific PCR assays targeting selected prevalent pathogens. Bacteriome profiling using nested amplification of low-volume samples was aided by a bioinformatic subtraction of signal contaminants from the recombinant polymerase, achieving a sensitivity slightly lower than that of specific PCR detection. Streptococcus pneumoniae was detected in 28 (31%) samples, Haemophilus influenzae in 24 (27%), Moraxella catarrhalis in 18 (20%), Staphylococcus spp. in 21 (23%), Turicella otitidis in 5 (5.6%), Alloiococcus otitidis in 3 (3.3%), and other bacteria in 14 (16%) using bacteriome profiling. S. pneumoniae was the dominant pathogen in 14 (16%) samples, H. influenzae in 15 (17%), M. catarrhalis in 5 (5.6%), T. otitidis in 2, and Staphylococcus auricularis in 2. Weaker signals of Prevotella melaninogenica, Veillonella dispar, and Veillonella montpellierensis were noted in several samples. Fourteen samples (16%) were not explainable by bacterial pathogens; novel causative agents were not detected. In conclusion, unbiased bacteriome profiling helped in depicting the true mutual quantitative ratios of ear bacteria, but at present, its complicated protocol impedes its routine clinical use. IMPORTANCE Although S. pneumoniae, H. influenzae, and M. catarrhalis have been long established as the most important pathogens in acute otitis media using culture and specific PCR assays, the knowledge of their mutual quantitative relations and possible roles of other bacteria is incomplete. The advent of unbiased bacteriome 16S rRNA gene profiling has allowed the detection of nearly all bacteria present in the sample, and it helps in depicting their mutual quantitative ratios. Due to the difficulties in performing mass sequencing in low-volume samples, only a few bacteriome-profiling studies of otitis media have been published, all limited to cases of chronic otitis media. Here, we present a study on samples obtained from young children with acute otitis media, successfully using a strategy of nested PCR coupled with mass sequencing, and demonstrate that the method can confer quantitative information hardly obtainable by other methods.

Acute otitis media increases middle ear susceptibility to nasal injection of

1994 ◽  
Vol 110 (1) ◽  
pp. 115-121 ◽  
Author(s):  
P ANTONELLI ◽  
S JUHN ◽  
C LE ◽  
G GIEBINK
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

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