Multicenter Surveillance of Streptococcus pneumoniae Isolates from Middle Ear and Mastoid Cultures in the 13-Valent Pneumococcal Conjugate Vaccine Era.

Clin Infect Dis. 2015 Feb 3. pii: civ067. [Epub ahead of print]

Multicenter Surveillance of Streptococcus pneumoniae Isolates from Middle Ear and Mastoid Cultures in the 13-Valent Pneumococcal Conjugate Vaccine Era.

Kaplan SL1, Center KJ2, Barson WJ3, Ling-Lin P4, Romero JR5, Bradley JS6, Tan TQ7, Hoffman JA8, Peters TR9, Gurtman A2, Scott DA2, Trammel J2, Gruber WC2, Hulten KG1, Mason EO1.

Author information

Abstract

BACKGROUND:

 Streptococcus pneumoniae is a common cause of otitis media (OM) in children; mastoiditis remains an important complication of OM. Limited data are available on the impact of the 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal otitis.

METHODS:

 Investigators from 8 children's hospitals in the United States prospectively collected pneumococcal isolates from middle ear or mastoid cultures from children during 2011 to 2013. Serotype and antibiotic susceptibilities were determined and PCV13 doses for children documented.

RESULTS:

 Over the three years the proportion of isolates included in PCV13 (plus a related serotype) decreased significantly (p=0.0006) among the middle ear/mastoid isolates [2011, 50% (74/149); 2012, 40.5% (47/116); 2013, 29% (34/118)]. The number of serotype 19A isolates in 2013 (n=12, 10.2% of total)) decreased 76% compared to the number of 19A isolates in 2011 (n=50, 33.6% of total). Of the children from whom serotype 19A was isolated (n=93), 55% had previously received<3 doses of PCV13. The most common non-PCV13 serotypes for the combined years were 35B (n=37), 21 (n=20), 23B (n=20), 15B (n=18), 11 (n=17), 23A (n=14), 15A (n=14), and 15C (n=14). The proportion of isolates with penicillin MIC >2 µg/mL decreased significantly over the three years. (2011, 22% [35/154]; 2012, 20% [24/118]; 2013, 10% [12/120]; p< 0.02).

CONCLUSIONS:

 The number of pneumococcal isolates and the percentage of isolates with high-level penicillin resistance from cultures taken from children with OM or mastoiditis for clinical indications have decreased following PCV13 use, largely related to decreases in serotype 19A isolates.

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PMID: 25648240 [PubMed - as supplied by publisher]