Epidemiology of OM Pathogens of Those Undergoing Tympanostomy Tube Placement in the Era of PCV13

Abstract

Objectives:

Determine the microbiology of otitis media (OM) since the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in March 2010.

Methods:

The population included pediatric patients undergoing tympanostomy tube placement between August 2012 and June 2013. Middle ear effusion was sent for aerobic culture and antibiotic susceptibility testing. Statistical analysis will be performed to compare those who received PCV13 and those who only received the PCV7 vaccine. Preliminary data from August 2012 to December 2012 included 72 ears, of which 21 had fluid. Seven of these 21 ears cultured Staphylococcus aureus, Haemophilus influenza, and Pseudomonas aeruginosa. Three patients with positive cultures of Staphylococcus or Haemophilus were vaccinated with at least one dose of PCV13, and 2 patients that cultured Staphylococcus or Pseudomonas had the PCV7 vaccine. All of the cultures were susceptible to a quinolone.

Results:

Two cultures of Staphylococcus and Haemophilus were resistant to Bactrim. The impact of PCV13 on the molecular epidemiology of OM will be profound, as two of the most common pneumococcal isolates from nasopharyngeal secretions in the post-PCV7 era, serotypes 19A and 6A, are included in PCV13. This study is the first to assess the OM microbiology in a pediatric population vaccinated with PCV13. Our study is currently limited by sample size; however, this has increased, as colonization is higher in fall and winter.

Conclusions:

This initial lack of Streptococcus cultures indicates that PCV13 is likely to have a significant impact on antibiotic resistance and rate of pneumococcal disease during the initial years following licensure.