Panel 6: Vaccines

Pettigrew, Melinda M.; Alderson, Mark R.; Barenkamp, Stephen J.; Håkansson, Anders P.; Mason, Kevin M.; Nokso-Koivisto, Johanna; Patel, Janak A.; Pelton, Stephen I.; Murphy, Timothy F.

doi:10.1177/0194599816632178

Cited by 18 publications

(12 citation statements)

References 119 publications

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“…The mechanism of this effect is not understood and all children in Nepal receive Vitamin A. The second intervention that has been shown to possibly reduce CSOM is pneumococcal immunisation which continues to be evaluated, with current reductions in acute otitis media of 6 to 43% reported from developed nations [28]. In addition, successful clinical treatment programs such as the Earbus in Western Australia report significant reductions in CSOM but need community engagement, skilled staff and intensive follow-up which is difficult to achieve in low resource settings such as Jumla [29].…”

Section: Discussionmentioning

confidence: 99%

Effect of a participatory intervention in women’s self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial

et al. 2019

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Background Chronic suppurative otitis media (CSOM) causes preventable deafness and disproportionately affects children living in poverty. Our hypothesis was that health promotion in women’s groups would increase their knowledge, attitudes and practices (KAP) regarding ear disease and reduce the prevalence of CSOM in their children. Methods We did a cluster randomised trial in two village development committees (VDCs) in Jumla, Nepal. In July 2014, 30 women’s groups were randomly allocated to intervention or control, stratified by VDC and distance to the road. The intervention groups participated in three sessions of health promotion using the WHO Hearing and Ear Care Training Resource Basic Level . The primary outcome was women’s KAP score and the secondary outcome was prevalence of CSOM in their children at 12 month follow-up. Analyses were by intention to treat. Participants and the research team were not masked to allocation. Results In June and July 2014 we recruited 508 women and 937 of their children. 12 months later there was no difference in the women’s KAP score (mean difference 0.14, 95% CI − 0.1 to 0.38, P = 0.25) or the prevalence of CSOM in their children (OR 1.10, 95%CI 0.62 to 1.84, P = 0.75) between intervention and control groups. However, overall, there was a significant improvement in the KAP score (mean difference − 0.51, 95% CI − 0.71,to − 0.31, P < 0.0001) and in the prevalence of CSOM from baseline 11.2% to follow-up 7.1% ( P < 0.0001). Conclusions Health promotion in women’s groups did not improve maternal KAP or reduce prevalence of CSOM. Over time there was a significant improvement in women’s KAP score and reduction in the prevalence of CSOM which may be attributable to our presence in the community offering treatment to affected children, talking to their parents and providing ciprofloxacin drops to the local health posts. More research is needed in low resource settings to test our findings. Trial registration Australia and New Zealand Clinical Trial Registry 12,614,000,231,640 ; Date of registration: 5.3.2014: Prospectively registered. Electronic supplementary material The online version of this article (10.1186/s12887-019-1539-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Effect of a participatory intervention in women’s self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial

et al. 2019

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“…Moraxella catarrhalis is a human respiratory tract pathogen that is often carried asymptomatically in the nasopharynx [1], but frequently causes otitis media (OM) in infants and children, and exacerbations of chronic obstructive pulmonary disease (COPD) in adults. Along with Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi), M. catarrhalis is among the most prevalent bacterial causes of OM where it is detected by PCR in up to 56% of middle ear fluid associated with OM [2]. M. catarrhalis also causes approximately ~ 10% of exacerbations of COPD each year in the USA [3].…”

Section: Introductionmentioning

confidence: 99%

The Moraxella catarrhalis phase-variable DNA methyltransferase ModM3 is an epigenetic regulator that affects bacterial survival in an in vivo model of otitis media

et al. 2019

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Background: Moraxella catarrhalis is a leading cause of otitis media (OM) and chronic obstructive pulmonary disease (COPD). M. catarrhalis contains a Type III DNA adenine methyltransferase (ModM) that is phase-variably expressed (i.e., its expression is subject to random, reversible ON/OFF switching). ModM has six target recognition domain alleles (modM1-6), and we have previously shown that modM2 is the predominant allele, while modM3 is associated with OM. Phase-variable DNA methyltransferases mediate epigenetic regulation and modulate pathogenesis in several bacteria. ModM2 of M. catarrhalis regulates the expression of a phasevarion containing genes important for colonization and infection. Here we describe the phase-variable expression of modM3, the ModM3 methylation site and the suite of genes regulated within the ModM3 phasevarion. Results: Phase-variable expression of modM3, mediated by variation in length of a 5′-(CAAC) n-3′ tetranucleotide repeat tract in the open reading frame was demonstrated in M. catarrhalis strain CCRI-195ME with GeneScan fragment length analysis and western immunoblot. We determined that ModM3 is an active N6-adenine methyltransferase that methylates the sequence 5′-AC m6 ATC-3′. Methylation was detected at all 4446 5′-ACATC-3′ sites in the genome when ModM3 is expressed. RNASeq analysis identified 31 genes that are differentially expressed between modM3 ON and OFF variants, including five genes that are involved in the response to oxidative and nitrosative stress, with potential roles in biofilm formation and survival in anaerobic environments. An in vivo chinchilla (Chinchilla lanigera) model of otitis media demonstrated that transbullar challenge with the modM3 OFF variant resulted in an increased middle ear bacterial load compared to a modM3 ON variant. In addition, co-infection experiments with NTHi and M. catarrhalis modM3 ON or modM3 OFF variants revealed that phase variation of modM3 altered survival of NTHi in the middle ear during early and late stage infection. Conclusions: Phase variation of ModM3 epigenetically regulates the expression of a phasevarion containing multiple genes that are potentially important in the progression of otitis media.

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“…The introduction of the pneumococcal conjugate vaccination (PCV) in the pediatric population has led to an important reduction of OM episodes caused by the serotypes included in the vaccine [46]. On the other hand, the introduction of pneumococcal vaccination programs has resulted in important modifications in OM microbiology: H. influenzae has become the most common otopathogen and OM episodes caused by M. catarrhalis have become more frequent; moreover, serotypes not included in PCVs have been more frequently identified as causative agents of diseases [47,48].…”

Section: Pneumococcal Vaccinationmentioning

confidence: 99%

Upper Respiratory Tract Microbiome and Otitis Media Intertalk: Lessons from the Literature

Folino

Ruggiero

Capaccio

et al. 2020

JCM

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Otitis media (OM) is one of the most common diseases occurring during childhood. Microbiological investigations concerning this topic have been primarily focused on the four classical otopathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes) mainly because most of the studies have been conducted with culture-dependent methods. In recent years, the introduction of culture-independent techniques has allowed high-throughput investigation of entire bacterial communities, leading to a better comprehension of the role of resident flora in health and disease. The upper respiratory tract (URT) is a region of major interest in otitis media pathogenesis, as it could serve as a source of pathogens for the middle ear (ME). Studies conducted with culture-independent methods in the URT and ME have provided novel insights on the pathogenesis of middle ear diseases through the identification of both possible new causative agents and of potential protective bacteria, showing that imbalances in bacterial communities could influence the natural history of otitis media in children. The aim of this review is to examine available evidence in microbiome research and otitis media in the pediatric age, with a focus on its different phenotypes: acute otitis media, otitis media with effusion and chronic suppurative otitis media.

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Panel 6: Vaccines

Cited by 18 publications

References 119 publications

Effect of a participatory intervention in women’s self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial

Effect of a participatory intervention in women’s self-help groups for the prevention of chronic suppurative otitis media in their children in Jumla Nepal: a cluster-randomised trial

The Moraxella catarrhalis phase-variable DNA methyltransferase ModM3 is an epigenetic regulator that affects bacterial survival in an in vivo model of otitis media

Upper Respiratory Tract Microbiome and Otitis Media Intertalk: Lessons from the Literature

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