Antibody response toStreptococcus pneumoniaeproteins PhtD, LytB, PcpA, PhtE and Ply after nasopharyngeal colonization and acute otitis media in children

SUMMARYIn order to study the epidemiology of acute otitis media (AOM) and Streptococcus pneumoniae nasopharyngeal colonization in the first 2 years of life, we followed up an unvaccinated birth cohort monthly and at visits when sick, with otoscopy to detect AOM and performed nasopharyngeal swabbing to detect S. pneumoniae. Serotyping of positive cultures was also performed. Of 210 babies who were enrolled at birth, 61 (29·05%) experienced 128 episodes of AOM [relative risk 2·63, 95% confidence interval (CI) 1·21–5·75] with maximum incidence in the second half of the first year of life. Episodes ranged from 1 to 7 (mean 2·1 episodes). Most (86·9%) babies with AOM had a positive culture swab giving an odds ratio (OR) of 1·93 (95% CI 1·03–3·62, P = 0·041) for this association. Other risk factors identified for AOM were winter season (OR 3·46, 95% CI 1·56–7·30, P = 0·001), upper respiratory infection (OR 2·43, 95% CI 1·43–4·51, P = 0·005); residents of small households were less likely to develop AOM (OR 0·32, 95% CI 0·17–0·57, P < 0·01). Common S. pneumoniae serotypes isolated during episodes were 19, 6, 15, 35, 7, 23, 9 and 10 which indicated a theoretical coverage for pneumococcal vaccines PCV10 and PCV13 constituent serotypes of 62·8%. We conclude that AOM in Indian infants is often associated with S. pneumoniae colonization of the nasopharynx as well as other risk factors.

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Correlation of higher antibody levels to pneumococcal proteins with protection from pneumococcal acute otitis media but not protection from nasopharyngeal colonization in young children

Clinical Microbiology and Infection ◽

10.1016/j.cmi.2017.01.011 ◽

2017 ◽

Vol 23 (7) ◽

pp. 487.e1-487.e6 ◽

Cited By ~ 4

Author(s):

Q. Xu ◽

J.R. Casey ◽

A. Almudevar ◽

M.E. Pichichero

Keyword(s):

Young Children ◽

Otitis Media ◽

Acute Otitis Media ◽

Nasopharyngeal Colonization ◽

Antibody Levels

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Changes Over Time in Nasopharyngeal Colonization in Children Under 2 Years of Age at the Time of Diagnosis of Acute Otitis Media (1999–2014)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy036 ◽

2018 ◽

Vol 5 (3) ◽

Cited By ~ 1

Author(s):

Judith M Martin ◽

Alejandro Hoberman ◽

Nader Shaikh ◽

Timothy Shope ◽

S onika Bhatnagar ◽

...

Keyword(s):

Otitis Media ◽

Susceptibility Testing ◽

Acute Otitis Media ◽

Initial Increase ◽

Prevalence Rates ◽

Nasopharyngeal Colonization ◽

Conjugate Vaccines ◽

Appropriate Treatment ◽

Changes Over Time ◽

Over Time

Abstract Background In children with acute otitis media (AOM), a decrease in nasopharyngeal (NP) colonization with vaccine serotypes of Streptococcus pneumoniae has been noted since the introduction of pneumococcal conjugate vaccines (PCVs). The purpose of this study is to describe corresponding changes in colonization with Haemophilus influenzae. Methods In 4 separate studies, we obtained NP cultures from children aged 6–23 months presenting with AOM. Cohort 1 was recruited before routine use of PCV7 (1999–2000); 93% of children in cohort 2 (2003–2005) and 100% in cohort 3 (2006–2009) received ≥2 doses of PCV7. All children in cohort 4 (2012–2014) received ≥2 doses of PCV13. Isolates of H. influenzae were tested for ß-lactamase production; ß-lactamase negative isolates from cohorts 3 and 4 underwent susceptibility testing. Results A total of 899 children were evaluated. NP colonization with H. influenzae was found in 26% of children in cohort 1 (n = 175), 41% in cohort 2 (n = 87), 33% in cohort 3 (n = 282), and 29% in cohort 4 (n = 355). Colonization with H. influenzae increased initially from cohort 1 to cohort 2 (P = .01), then decreased across cohorts 2, 3, and 4 (P = .03, test for trend). The prevalence rates of ß-lactamase production were 27%, 42%, 33%, and 30% in each of the 4 cohorts, respectively (P = .50). Conclusions Although an initial increase in H. influenzae colonization was observed, suggesting an impact of PCVs, the most recent prevalence rates of NP colonization with H. influenzae and ß-lactamase production were like those observed before universal administration of PCV7. This knowledge is critical to guide appropriate treatment recommendations for children with AOM.

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Immunologic Response to Pneumococcal Polysaccharide Vaccine in Infants

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894800890s382 ◽

1980 ◽

Vol 89 (3_suppl) ◽

pp. 351-356 ◽

Cited By ~ 8

Author(s):

John L. Sloyer ◽

Laurel J. Karr ◽

John H. Ploussard ◽

Gerald D. Schiffman

Keyword(s):

Antibody Response ◽

Otitis Media ◽

Natural Infection ◽

Young Infant ◽

Serum Antibody ◽

Capsular Polysaccharides ◽

Igg Antibody ◽

Nasopharyngeal Colonization ◽

Antibody Levels ◽

Group 1

The serum antibody response to purified pneumococcal capsular polysaccharides (PCP) was determined in four groups of infants ranging in age from 3 to 24 months. Group 1 consisted of eight infants immunized with an octavalent vaccine containing serotypes 1, 3, 6, 7, 14, 18, 19 and 23 (PCP-8). Group 1 received 25 μg of each serotype at 3–6 months of age and again at 18–24 months. The antibody response after the second immunization was compared to a group of nine patients receiving a primary immunization at 18–24 months and to a group of ten age-matched controls receiving saline placebo. There were no significant differences in mean serum antibody levels between the two groups receiving the PCP-8. A fourth group of 44 infants between 6 and 21 months of age received either PCP-7 or PCP-8 and were followed for two years, at which time simultaneous injections of both vaccines were administered. Types 2, 3, 7, and 8 were most immunogenic but levels six months after immunization were approximately the same as for unimmunized controls with the exception of serotypes 3 and 7 which persisted for about two years. The class of antibody induced either by natural infection or by immunization was preferentially IgG and it was more often induced by the former. There were no significant differences between the serotypes of pneumococci isolated from nasopharyngeal cultures regardless of which vaccine was administered. Finally, the least immunogenic serotypes include 4, 6, 14, 19, and 23 and these are the only serotypes thus far associated with otitis media after immunization. The results suggest that PCP do not induce a lasting immune tolerance at the dose administered in this study; PCP are not very immunogenic in the young infant; PCP antibody tends to rise naturally; IgG antibody is preferentially induced; nasopharyngeal colonization is not altered by PCP immunization; and an association may exist between PCP immunogenicity and subsequent onset of otitis media.

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Pneumococcal Otitis Media following Middle Ear Deflation

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948109000119 ◽

1981 ◽

Vol 90 (1) ◽

pp. 72-76 ◽

Cited By ~ 13

Author(s):

William L. Meyerhoff ◽

G. Scott Giebink ◽

Donald Shea

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Endolymphatic Hydrops ◽

Acute Otitis Media ◽

Scala Tympani ◽

Nasopharyngeal Colonization ◽

Normal Morphology ◽

Time Period ◽

Middle Ear Pressure ◽

Histologic Changes

Temporal bone histology has been studied in chinchillas following middle ear deflation in the presence of nasopharyngeal colonization with S pneumoniae. All animals sacrificed within one hour following deflation had similar middle ear hsitology regardless of whether or not the animals had been colonized with S pneumoniae. All animals with negative nasopharyngeal culture for S pneumoniae sacrificed from 3–24 days following − 30 mm Hg negative middle ear pressure had negative middle ear cultures and normal morphology. During the same time period, however, nearly 60% of animals colonized with S pneumoniae developed acute otitis media with positive middle ear cultures for S pneumoniae. Histologic changes in the middle ear included the presence of effusion, leukocytes, granulation tissue, osteoneogenesis, mucosal metaplasia, and hemorrhage. Changes in the inner ear were much less frequent and included some leukocyte infiltration with hyperemia in the scala tympani and endolymphatic hydrops.

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