Changes Over Time in Nasopharyngeal Colonization in Children Under 2 Years of Age at the Time of Diagnosis of Acute Otitis Media (1999-2014).
Changes Over Time in Nasopharyngeal Colonization in Children Under 2 Years of Age at the Time of Diagnosis of Acute Otitis Media (1999-2014).
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DOI：
10.1093/ofid/ofy036
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发表时间：
2018-03
影响因子：
4.2
通讯作者：
Green M
中科院分区：
文献类型：
--
作者：
Martin JM;Hoberman A;Shaikh N;Shope T;Onika Bhatnagar S;Block SL;Haralam MA;Kurs-Lasky M;Green M
在患有急性中耳炎（AOM）的儿童中，自从引入肺炎球菌结合疫苗（PCVs）以来，已经注意到肺炎链球菌疫苗血清型鼻咽（NP）定植减少。本研究的目的是描述流感嗜血杆菌定殖的相应变化。在4项独立的研究中，我们对6-23个月的AOM患儿进行了NP培养。队列1在常规使用PCV7之前招募（1999-2000）；队列2（2003-2005）中93%的儿童和队列3（2006-2009）中100%的儿童接种了≥2剂PCV7。队列4（2012-2014）的所有儿童均接受了≥2剂PCV13。对流感嗜血杆菌分离株进行ß-内酰胺酶产率检测；对队列3和队列4中ß-内酰胺酶阴性的分离株进行药敏试验。共有899名儿童接受了评估。队列1中有26%的儿童（n = 175）、队列2中有41% （n = 87）、队列3中有33% （n = 282）、队列4中有29% （n = 355）存在流感嗜血杆菌的NP定植。从队列1到队列2，流感嗜血杆菌的定植最初增加（P = 0.01），然后在队列2、3和4中减少（P = 0.03，趋势检验）。4个队列中ß-内酰胺酶产生的患病率分别为27%、42%、33%和30% （P = 0.50）。虽然观察到流感嗜血杆菌定植的初始增加，提示pcv的影响，但最近流感嗜血杆菌定植和ß-内酰胺酶产生的NP流行率与普遍给予PCV7之前观察到的相似。这一知识对于指导AOM患儿的适当治疗建议至关重要。
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. 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. 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). 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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影响因子：
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