Korean J Pediatr Infect Dis.  2008 May;15(1):44-50. 10.14776/kjpid.2008.15.1.44.

Serotype Distribution of Pneumococcus Isolated from the Ear Discharge in Children with Otitis Media in 2001–2006

• Lee TJ
• Chun JK
• Kim KH
• Kim KJ
• Kim DS

• KMID: 2439941
• DOI: http://doi.org/10.14776/kjpid.2008.15.1.44

Abstract

PURPOSE
Better understanding of the epidemiology of Streptococcus pneumoniae affects preventive and therapeutic strategies for children with otitis media. This study was undertaken to examine the prevalence of pneumococcal serotypes causing otitis media in children.
METHODS
Pneumococcal isolates obtained from the ear discharge of children with otitis media between January 2001 and December 2006 were characterized by serotyping and antibiotic susceptibility testing.
RESULTS
There were 54 pneumococcal isolates from 54 children with otitis media. The median age of patients was 13 months, and the proportion of children < 5 years old was 81%. The predominant serotypes, in order of decreasing frequency, were 19A (44%), 19F (28%), 6B (7%), 6A (4%), 9V (4%), and 1 (4%); 23 isolates (43%) belonged to types included in the heptavalent pneumococcal conjugate vaccine (PCV7). The proportion of serotype 19A and 19F accounted for 72% of overall pneumococcal isolates, which accounted for 84% of pneumococcal isolates from otorrhea of children < 5 years old (vs 20% in children ≥5 years old, P < 0.001). All serotypes isolated from 3 vaccinees of PCV7 were 19A. There was no significant diminution in otitis media caused by pneumococcal vaccine serotypes after the introduction of PCV7. The frequency of nonsusceptibility to penicillin, erythromycin, and trimethoprim-sulfamethoxazole was higher in serotype 19A than in other non-vaccine serotypes, respectively. The frequency of multiple drug resistance was 96% in serotype 19A, compared with 29% in other non-vaccine serotypes (P=0.001).
CONCLUSION
19A was the most common pneumococcal serotype causing otitis media and represented a large proportion of strains with multiple drug resistance in children younger than 5 years of age.

Keyword

Streptococcus pneumoniae; Otitis media; Serotype

MeSH Terms

Child*
Drug Resistance, Multiple
Ear*
Epidemiology
Erythromycin
Heptavalent Pneumococcal Conjugate Vaccine
Humans
Otitis Media*
Otitis*
Penicillins
Prevalence
Serogroup*
Serotyping
Streptococcus pneumoniae*
Trimethoprim, Sulfamethoxazole Drug Combination
Erythromycin
Heptavalent Pneumococcal Conjugate Vaccine
Penicillins
Trimethoprim, Sulfamethoxazole Drug Combination