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The objective of the present review was to summarize the currently available literature data on etiology of acute otitis media in the children, the role of biofilms in the development of this pathology, and sensitivity of its principal causative factors to various antibiotic medications. The secondary objective was to elaborate the practical guidelines for the prevention of acute otitis media in the children.

Streptococcus pneumoniae, a common human pathogen, colonizes the nasopharynx and causes diseases including acute otitis media (AOM). Herein, pneumococcal serotype distributions in children before and after PCV7 vaccination and in patients with pneumococcal disease in Siberian Russia (Krasnoyarsk) are reported. Analyses included antimicrobial susceptibility testing, sequence typing (ST), pulsed field gel electrophoresis, virulence‐related surface protein gene (VSG) typing with novel primers and structural analysis by scanning electron microscopy. In healthy children (HC) prior to administration of PCV7, drug‐susceptible serotype23F/ST1500 was a major pneumococcal genotype. In the PCV7 trial, multidrug‐resistant serotype19A/ST320 emerged in vaccinees after PCV7, exhibiting a PCV7‐induced serotype replacement. Multidrug‐resistant serotype19A/ST320 was evident in patients with AOM. Community‐acquired pneumonia (CAP) isolates showed genetic similarities to the AOM (ST320) genotype, constituting a common non‐invasive AOM–CAP group. In contrast, meningitis isolates were more divergent. Overall, 25 ST types were identified; five (20%) of which were Krasnoyarsk‐native. Regarding VSGs, PI‐1 (rlrA/rrgB), PI‐2 (pitA/B), psrP and cbpA were present at 54.3%, 38.6%, 48.6%, and 95.7%, respectively, with two major VSG content types, PI‐1−/PI‐2−/psrP +/cbpA + and PI‐1+/PI‐2+/psrP ‐/cbpA +, being found for HC and non‐invasive diseases, respectively. A major clone of serotype19A/ST320 (PI‐1+/PI‐2+) produced the longest pneumococcal wire (pilus) structures in colonies. ST1016 (PI‐1−/PI‐2−) in HC had HEp‐2 cell‐adherent pili. These results suggest that serotype19A/ST320 and related genotypes, with the VSG content type PI‐1+/PI‐2+/psrP −/cbpA +, emerged in vaccinees after PCV7 in Siberia, accompanying diseases in non‐vaccinated children, and that some genotypes (serotypes19A/ST320 and 18/ST1016) produced novel pneumococcal structures, predicting their roles in colony formation and adherence.

Вакцинопрофилактика. 2018; 17 (3): 63-67. DOI: 10.31631/2073 17 (3): 63-67. DOI: 10.31631/ -3046-2018 DOI: 10.31631/2073DOI: 10.31631/ -3046-2018

1 ФГБОУ ВО «Красноярский государственный медицинский университет имени профессора В. Ф. Войно-Ясенецкого» Минздрава России, Красноярск, Россия 2 КГБУЗ «Красноярская межрайонная детская больница №4», Красноярск, Россия 3 КГБУЗ «Красноярская межрайонная детская клиническая больница №1», Красноярск, Россия Цель: выявление этиологической роли, исследования серотипового пейзажа и определения преобладающих генотипов (сиквенс-типов) Streptococcus pneumoniae у 459 детей, госпитализированных по поводу острого гнойного среднего отита, острого тонзиллита, внебольничной пневмонии, гнойного бактериального менингита. Материалы и методы: Использовался культуральный (бактериологический) метод, молекулярные методы (ПЦР, секвенирование). Статистическая обработка проводилась с помощью программ Microsoft Excel 2007 и Statistica 6.0. Результаты: S. pneumoniae был выявлен в 16,8% случаев. Преобладали серотипы 19F (39,7%) и 19A (13,2%), относящиеся к мультирезистентному клональному комплексу 320. С меньшей частотой (8,82%) встречались пневмококки 6 серогруппы (6АВ)представители клонального комплекса 315, характеризующиеся устойчивостью к макролидам, клиндамицину и тетрациклину. Соответствие выявленных серотипов антигенному составу пневмококковых вакцин составило от 70,6% до 88,2%. Ключевые слова: Streptococcus pneumoniae, пневмококк, этиологическая роль, серотипы у детей, сиквенс-типы, резистентностьObjective: To study the etiological role, serotype distribution and prevalent Streptococcus pneumoniae genotypes (sequence types) in 459 children hospitalized with acute purulent otitis media, acute tonsillitis, community-acquired pneumonia, and purulent bacterial meningitis. Pneumococcal cultures isolated from patients were tested for sensitivity to antimicrobials, and presence of resistance genes. Materials and Methods: The cultural and molecular methods (PCR, sequencing) were used. Statistical analysis was carried out using Microsoft Excel 2007 and Statistica 6.0. Results: S. pneumoniae was detected in 16,8%. The prevalent serotypes were 19F (39.7%) and 19A (13.2%) -representatives of multidrug-resistant clonal complex 320. Isolates of serogroup 6 (6AB, 8.82%) belonged to clonal complex 315, and characterized by resistance to macrolides, clindamycin and tetracycline. From 70.6% to 88.2% of S. pneumoniae serotypes isolated from patients corresponded to «vaccine»-types.

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