Acute Otitis Media Otopathogens During 2008 to 2010 in Rochester, New York
Acute Otitis Media Otopathogens During 2008 to 2010 in Rochester, New York
复制标题
DOI：
10.1097/inf.0b013e31828d9acc
复制
发表时间：
2013-08-01
影响因子：
3.6
通讯作者：
Pichichero, Michael E.
中科院分区：
文献类型：
--
作者：
Casey, Janet R.;Kaur, Ravinder;Pichichero, Michael E.
背景资料：耳病原体分布定植鼻咽部（NP），并导致急性中耳炎（AOM）是在流量引入肺炎球菌结合疫苗7（PCV 7），并将继续change.Methods：二百七十七名儿童进行了前瞻性随访;鼓室穿刺术进行AOM和208 NP样本收集到比较与中耳液（MEF）分离株。在6至30月龄的7次健康访视时收集了863份NP样本。所有儿童均接受PCV 7，直至2010年4月被PCV 13取代。结果：在本研究的时间范围内，MEF中耳致病菌的分布是稳定的。几乎不存在PCV 7血清型肺炎球菌。S.肺炎链球菌的感染率为26-36%，而无法分型的流感嗜血杆菌的感染率为28-34%。卡他莫拉菌分离较少见，7- 18%。S.对青霉素不敏感的肺炎链球菌在3年内稳定，为40- 52%。所有的M。卡他性鼻炎和34%的非分型H.流感病毒产生β-内酰胺酶。耳病原体在AOM发作时的NP分离株包括来自MEF的分离株，并且与健康时的分布不同。序列类型320和199为S.结论：耳源性中耳炎的病原菌分布、耐药性及菌株多样性与耳源性中耳炎的发生、发展密切相关。2008年至2010年底期间，肺炎菌种类保持稳定。耳病原体在AOM发作时的NP分离更好地反映了，虽然不完全，可能MEF分离株相比，NP分离株在健康的时候。
Background: The otopathogen distribution colonizing the nasopharynx (NP) and causing acute otitis media (AOM) is in flux following the introduction of pneumococcal conjugate vaccine 7 (PCV7) and will continue to change.Methods: Two hundred seventy-seven children were followed prospectively; tympanocentesis was performed during AOM and 208 NP samples were collected to compare with middle ear fluid (MEF) isolates. Eight hundred sixty-three NP samples were collected at 7 healthy visits between 6 and 30 months of age. All children received PCV7 until April 2010 when it was substituted by PCV13. Multilocus sequence typing was used to speciate Streptococcus pneumoniae.Results: The distribution of otopathogens in the MEF during the study time frame was stable. PCV7 serotypes of pneumococci were virtually absent. The frequency of isolation of S. pneumoniae was 26-36% compared with 28-34% for nontypeable Haemophilus influenzae. Moraxella catarrhalis isolation was less common, 7-18%. The proportion of S. pneumoniae that were penicillin nonsusceptible was stable during the 3 years, 40-52%. All M. catarrhalis and 34% of nontypeable H. influenzae were beta-lactamase producing. NP isolates of otopathogens at onset of AOM included the isolate from the MEF and was dissimilar from the distribution at times of health. Sequence types 320 and 199 of S. pneumoniae expressing serotypes 19A and 15 most often caused AOM.Conclusions: The otopathogen distribution, antibiotic susceptibility and the diversity of strains within the S. pneumoniae species during 2008 through late 2010 were stable. NP isolation of otopathogens at onset of AOM better reflected, albeit incompletely, likely MEF isolates compared with NP isolates at times of health.