The effect of immunization with pneumococcal conjugated vaccines on Streptococcus pneumoniae resistance patterns in acute otitis media

Abstract

Following the introduction of 7- and 13-pneumococcal conjugate vaccines (PCVs) in Israel, we demonstrated that within Streptococcus pneumoniae (Sp) positive middle ear cultures, obtained from young children with severe acute otitis media (AOM) episodes, there were more penicillin-susceptible and less multi-drug resistant Sp isolates in PCV immunized children.

Etiology of acute otitis media and serotype distribution of Streptococcus pneumoniae and Haemophilus influenzae in Chilean children <5 years of age

“…[ 5 – 8 ] Recent studies had raised concerns with S pneumoniae developing resistance against penicillin and other antibiotics. [ 47 , 48 ] Contrary to this, the results of the present study showed only 5.2% of S pneumoniae positive episodes to have complete resistance to penicillin, which is in line with previous studies conducted in Chile, Colombia, Mexico, and Costa Rica. [ 21 , 22 , 25 , 26 , 31 – 33 , 40 , 41 ]…”

Acute otitis media guidelines in selected developed and developing countries: uniformity and diversity

“…Recommending amoxicillin as the first-line therapy has been found to positively affect the resistance patterns of Streptococcus pneumoniae isolated from middle ear fluid or AOM-associated otorrhoea in French and Israeli PCV immunised children 24 25. Disagreement on the dosage and duration of antibiotic therapy were noted in the studied guidelines.…”

“…In contrast, countries that implemented AOM guidelines have already reported reduced rates of appropriate antibiotic prescription for AOM and low resistance rates in isolated pathogens 24 25 31…”

Antibiotic Recommendations for Acute Otitis Media and Acute Bacterial Sinusitis

“…6,11,12,15 This decline is largely due to a dramatic decrease in cases of AOM attributable to S. pneumoniae (including pen-R S. pneumoniae ) as documented both in the U.S., 6,14,16 Iceland 17 and Israel (south and central). 11–13 Going hand-in-hand with these observations are reports from Israel, 18 France 7,19 and the U.S. 6,8,20 indicating there is a substantial decrease in nasopharyngeal colonization with vaccine strains of S. pneumoniae with a relative increase in non-vaccine strains. In all but one of these studies, 8 there was a concurrent decrease in penicillin and ceftriaxone resistant strains of S. pneumoniae .…”

“…6,10–12 With the decrease of nasopharyngeal colonization with vaccine strains, there has also been a decrease in AOM caused by pen-R S. pneumoniae . 13,14 Both of these observations underscore the basic principle that nasopharyngeal colonization with S. pneumoniae is a necessary prelude to the development of either AOM or ABS with that organism.…”