What is behind the ear drum? The microbiology of otitis media and the nasopharyngeal flora in children in the era of pneumococcal vaccination. (1st September 2014)

• Record Type: Journal Article
• Authors: Mills, Nikki; Best, Emma J; Murdoch, David; Souter, Melanie; Neeff, Michel; Anderson, Trevor; Salkeld, Lesley; Ahmad, Zahoor; Mahadevan, Murali; Barber, Colin; Brown, Colin; Walker, Cameron; Walls, Tony
• Is Part Of: Journal of paediatrics and child health. Volume 51:Number 3(2015:Mar.)
• Page Start: 300
• Page End: 306
• Publication Date: 2014-09-01
• Subjects: Children -- Health and hygiene -- Periodicals; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/jpc.12710
• Languages: English
• ISSNs: 1034-4810

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jpc12710-sec-0001" sec-type="section"> <title>Aim</title> <p>This study aims to describe the microbiology of middle ear fluid (MEF) in a cohort of children vaccinated with <italic>S</italic><italic>treptococcus pneumoniae</italic> conjugate vaccine (PCV7) having ventilation tube insertion. Nasopharyngeal (NP) carriage of otopathogens in these children is compared with children without history of otitis media.</p> </sec> <sec id="jpc12710-sec-0002" sec-type="section"> <title>Methods</title> <p>Between May and November 2011, MEF and NP samples from 325 children aged <3 years were collected in three major centres in New Zealand at the time of ventilation tube insertion. An age‐matched non‐otitis‐prone comparison group of 137 children had NP samples taken. A questionnaire was completed by both groups.</p> </sec> <sec id="jpc12710-sec-0003" sec-type="section"> <title>Results</title> <p>Immunisation coverage with at least one dose of PCV7 was 97%. <italic>H</italic><italic>aemophilus influenzae</italic> was cultured in 19.4% of MEF and was polymerase chain reaction (PCR) positive in 43.4%. <italic>S</italic><italic>. pneumoniae</italic> and <italic>M</italic><italic>oraxella catarrhalis</italic> were cultured in <10% of MEF samples but were PCR positive for 23.1% and 38.7%, respectively. <italic>H</italic><italic>. influenzae</italic> was the most common organism isolated from NP samples (60%) in the grommet group, while <italic>M</italic><italic>. catarrhalis</italic> (56%) was the most common in the non‐otitis prone group. <italic>S</italic><italic>. pneumoniae</italic> was more commonly found in the nasopharynx of children with ear disease (41% vs. 29%). 19F was the most prominent <italic>S</italic><italic>. pneumoniae</italic> serotype in NP samples of both groups, but no serotype dominated in MEF. Ninety‐five per cent of <italic>H</italic><italic>. influenzae</italic> isolates were confirmed to be non‐typeable <italic>H</italic><italic>. influenzae.</italic></p> </sec> <sec id="jpc12710-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In this cohort of children with established ear disease requiring surgical intervention, non‐typeable <italic>H</italic><italic>. influenzae</italic> is the dominant pathogen in both the nasopharynx and MEF.</p> </sec> </abstract>