Predominance of nontypeable Haemophilus influenzae in children with otitis media following introduction of a 3+0 pneumococcal conjugate vaccine schedule

Selma Wiertsema, Lea-Ann Kirkham, K.J. Corscadden, E.N. Mowe, J.M. Bowman, P. Jacoby, R. Francis, Shyan Vijayasekaran, Harvey Coates, Thomas Riley, Peter Richmond

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

In Australia the 7-valent pneumococcal conjugate vaccine (PCV7) is administered at 2, 4 and 6 months of age, with no booster dose. Information on bacterial carriage and the aetiology of recurrent acute otitis media (rAOM) after introduction of PCV7 using the 3 + 0 schedule is required to evaluate the potential impact of second generation pneumococcal vaccines. We found that 2-4 years after introduction of PCV7 in the National Immunisation Program, nontypeable Haemophilus influenzae (NTHi) was the predominant pathogen isolated from the nasopharynx and middle ear of children with a history of rAOM. Compared with healthy controls (n = 81), NTHi and Streptococcus pneumoniae carriage rates were significantly higher in children with a history of rAOM (n = 186) (19% vs. 56%p <0.0001 and 26% vs. 41%, p = 0.02, respectively). Carriage of PCV7 pneumococcal serotypes was rare, whereas PCV7-related and non-PCV7 serotypes were isolated of 38% of cases and 24% of controls. Serotype 19A was the most common serotype isolated from the nasopharynx and middle ear and accounted for 36% (14/39) of total pneumococcal isolates with reduced susceptibility to cotrimoxazole. Of the 119 children carrying NTHi, 17% of isolates were beta-lactamase positive.The scarcity of PCV7 serotypes in children with and without a history of rAOM indicates that the 3 + 0 PCV7 schedule is preventing carriage and rAOM from PCV7 serotypes. Introduction of new vaccines in Australia with increased pneumococcal serotype and pathogen coverage, including 19A and NTHi, should decrease the circulation of antibiotic-resistant bacteria and reduce the burden of rAOM. (C) 2011 Published by Elsevier Ltd.
Original languageEnglish
Pages (from-to)5163-5170
JournalVaccine
Volume29
Issue number32
DOIs
Publication statusPublished - 2011

Fingerprint

otitis media
Haemophilus influenzae
Conjugate Vaccines
Pneumococcal Vaccines
Otitis Media
Appointments and Schedules
serotypes
vaccines
nasopharynx
Nasopharynx
Middle Ear
ears
Immunization Programs
Streptococcus pneumoniae
beta-lactamase
pathogens
Sulfamethoxazole Drug Combination Trimethoprim
beta-Lactamases
Serogroup
etiology

Cite this

@article{ccbb033511aa49eda2d3ad0b2ff4ab8a,
title = "Predominance of nontypeable Haemophilus influenzae in children with otitis media following introduction of a 3+0 pneumococcal conjugate vaccine schedule",
abstract = "In Australia the 7-valent pneumococcal conjugate vaccine (PCV7) is administered at 2, 4 and 6 months of age, with no booster dose. Information on bacterial carriage and the aetiology of recurrent acute otitis media (rAOM) after introduction of PCV7 using the 3 + 0 schedule is required to evaluate the potential impact of second generation pneumococcal vaccines. We found that 2-4 years after introduction of PCV7 in the National Immunisation Program, nontypeable Haemophilus influenzae (NTHi) was the predominant pathogen isolated from the nasopharynx and middle ear of children with a history of rAOM. Compared with healthy controls (n = 81), NTHi and Streptococcus pneumoniae carriage rates were significantly higher in children with a history of rAOM (n = 186) (19{\%} vs. 56{\%}p <0.0001 and 26{\%} vs. 41{\%}, p = 0.02, respectively). Carriage of PCV7 pneumococcal serotypes was rare, whereas PCV7-related and non-PCV7 serotypes were isolated of 38{\%} of cases and 24{\%} of controls. Serotype 19A was the most common serotype isolated from the nasopharynx and middle ear and accounted for 36{\%} (14/39) of total pneumococcal isolates with reduced susceptibility to cotrimoxazole. Of the 119 children carrying NTHi, 17{\%} of isolates were beta-lactamase positive.The scarcity of PCV7 serotypes in children with and without a history of rAOM indicates that the 3 + 0 PCV7 schedule is preventing carriage and rAOM from PCV7 serotypes. Introduction of new vaccines in Australia with increased pneumococcal serotype and pathogen coverage, including 19A and NTHi, should decrease the circulation of antibiotic-resistant bacteria and reduce the burden of rAOM. (C) 2011 Published by Elsevier Ltd.",
author = "Selma Wiertsema and Lea-Ann Kirkham and K.J. Corscadden and E.N. Mowe and J.M. Bowman and P. Jacoby and R. Francis and Shyan Vijayasekaran and Harvey Coates and Thomas Riley and Peter Richmond",
year = "2011",
doi = "10.1016/j.vaccine.2011.05.035",
language = "English",
volume = "29",
pages = "5163--5170",
journal = "Vaccine",
issn = "0264-410X",
publisher = "Elsevier",
number = "32",

}

Predominance of nontypeable Haemophilus influenzae in children with otitis media following introduction of a 3+0 pneumococcal conjugate vaccine schedule. / Wiertsema, Selma; Kirkham, Lea-Ann; Corscadden, K.J.; Mowe, E.N.; Bowman, J.M.; Jacoby, P.; Francis, R.; Vijayasekaran, Shyan; Coates, Harvey; Riley, Thomas; Richmond, Peter.

In: Vaccine, Vol. 29, No. 32, 2011, p. 5163-5170.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predominance of nontypeable Haemophilus influenzae in children with otitis media following introduction of a 3+0 pneumococcal conjugate vaccine schedule

AU - Wiertsema, Selma

AU - Kirkham, Lea-Ann

AU - Corscadden, K.J.

AU - Mowe, E.N.

AU - Bowman, J.M.

AU - Jacoby, P.

AU - Francis, R.

AU - Vijayasekaran, Shyan

AU - Coates, Harvey

AU - Riley, Thomas

AU - Richmond, Peter

PY - 2011

Y1 - 2011

N2 - In Australia the 7-valent pneumococcal conjugate vaccine (PCV7) is administered at 2, 4 and 6 months of age, with no booster dose. Information on bacterial carriage and the aetiology of recurrent acute otitis media (rAOM) after introduction of PCV7 using the 3 + 0 schedule is required to evaluate the potential impact of second generation pneumococcal vaccines. We found that 2-4 years after introduction of PCV7 in the National Immunisation Program, nontypeable Haemophilus influenzae (NTHi) was the predominant pathogen isolated from the nasopharynx and middle ear of children with a history of rAOM. Compared with healthy controls (n = 81), NTHi and Streptococcus pneumoniae carriage rates were significantly higher in children with a history of rAOM (n = 186) (19% vs. 56%p <0.0001 and 26% vs. 41%, p = 0.02, respectively). Carriage of PCV7 pneumococcal serotypes was rare, whereas PCV7-related and non-PCV7 serotypes were isolated of 38% of cases and 24% of controls. Serotype 19A was the most common serotype isolated from the nasopharynx and middle ear and accounted for 36% (14/39) of total pneumococcal isolates with reduced susceptibility to cotrimoxazole. Of the 119 children carrying NTHi, 17% of isolates were beta-lactamase positive.The scarcity of PCV7 serotypes in children with and without a history of rAOM indicates that the 3 + 0 PCV7 schedule is preventing carriage and rAOM from PCV7 serotypes. Introduction of new vaccines in Australia with increased pneumococcal serotype and pathogen coverage, including 19A and NTHi, should decrease the circulation of antibiotic-resistant bacteria and reduce the burden of rAOM. (C) 2011 Published by Elsevier Ltd.

AB - In Australia the 7-valent pneumococcal conjugate vaccine (PCV7) is administered at 2, 4 and 6 months of age, with no booster dose. Information on bacterial carriage and the aetiology of recurrent acute otitis media (rAOM) after introduction of PCV7 using the 3 + 0 schedule is required to evaluate the potential impact of second generation pneumococcal vaccines. We found that 2-4 years after introduction of PCV7 in the National Immunisation Program, nontypeable Haemophilus influenzae (NTHi) was the predominant pathogen isolated from the nasopharynx and middle ear of children with a history of rAOM. Compared with healthy controls (n = 81), NTHi and Streptococcus pneumoniae carriage rates were significantly higher in children with a history of rAOM (n = 186) (19% vs. 56%p <0.0001 and 26% vs. 41%, p = 0.02, respectively). Carriage of PCV7 pneumococcal serotypes was rare, whereas PCV7-related and non-PCV7 serotypes were isolated of 38% of cases and 24% of controls. Serotype 19A was the most common serotype isolated from the nasopharynx and middle ear and accounted for 36% (14/39) of total pneumococcal isolates with reduced susceptibility to cotrimoxazole. Of the 119 children carrying NTHi, 17% of isolates were beta-lactamase positive.The scarcity of PCV7 serotypes in children with and without a history of rAOM indicates that the 3 + 0 PCV7 schedule is preventing carriage and rAOM from PCV7 serotypes. Introduction of new vaccines in Australia with increased pneumococcal serotype and pathogen coverage, including 19A and NTHi, should decrease the circulation of antibiotic-resistant bacteria and reduce the burden of rAOM. (C) 2011 Published by Elsevier Ltd.

U2 - 10.1016/j.vaccine.2011.05.035

DO - 10.1016/j.vaccine.2011.05.035

M3 - Article

VL - 29

SP - 5163

EP - 5170

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 32

ER -