Acute otitis media caused by Streptococcus pneumoniae serotype 19A ST320 clone: epidemiological and clinical characteristics
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
51
Journal Issue
3
Pages
337-343
Date Issued
2018
Author(s)
Abstract
Background: Streptococcus pneumoniae serotype 19A ST320, a highly multiresistant and virulent clone, has emerged as a common pathogen causing acute otitis media (AOM) in children. Methods: Patients aged 0–18 years with AOM who presented at Mackay Memorial Hospital, Taipei, Taiwan were prospectively enrolled between December 1, 2009, and November 30, 2012. For each patient, a specimen of middle-ear fluid was obtained and cultured. S. pneumoniae isolates were tested by serotyping, antibiotic-resistance profiling, and multilocus sequence typing. Demographic characteristics and clinical history of patients with pneumococcal AOM were recorded. Results: Pneumococcal AOM was observed in 108 (24.8%) of 436 episodes. One hundred and four isolates of S. pneumoniae were available for study. The most common serotypes were 19A (67 isolates, 64.4%), followed by 19F (16 isolates, 15.4%), and 3 (7 isolates, 6.7%). Among the 85 sequence-typed isolates, Serotype 19A ST320 (50, 58.8%) was the most frequent. Children with AOM caused by Serotype 19A ST320 were younger (33.9 ± 21.4 months vs. 46.7 ± 35.9 months, p = 0.04) and had a higher rate of spontaneous rupture of the tympanic membrane (64.0% vs. 40%, p = 0.05) than those caused by isolates of other sequence types. Serotype 19A ST320 caused 90% of AOM episodes in children aged ? 12 months and had had higher resistance rates to penicillin according to meningeal breakpoints (p = 0.011), amoxicillin (p < 0.001) and trimethoprim/sulfamethoxazol (p < 0.001). Conclusions: It is better to use pneumococcal conjugate vaccine effective against Serotype 19A in early infancy to prevent the first and subsequent episodes of AOM in children in Taiwan. ? 2017
Subjects
acute otitis media; Serotype 19A; Streptococcus pneumoniae
SDGs
Other Subjects
amoxicillin; amoxicillin plus clavulanic acid; cefixime; cefotaxime; ceftriaxone; chloramphenicol; cotrimoxazole; erythromycin; levofloxacin; penicillin derivative; Pneumococcus vaccine; tetracycline; vancomycin; amoxicillin; antiinfective agent; penicillin derivative; sulfamethoxazole; trimethoprim; vaccine; acute otitis media; adolescent; adult; antibiotic resistance; Article; bacterial strain; bacterium culture; bacterium isolate; child; clinical article; clinical feature; clone; drug efficacy; eardrum perforation; epidemiological data; female; Haemophilus influenzae; human; infant; male; middle ear; Moraxella catarrhalis; multilocus sequence typing; newborn; nonhuman; prospective study; serotyping; Streptococcus pneumoniae; Streptococcus pyogenes; Taiwan; classification; genetics; immunology; isolation and purification; microbial sensitivity test; microbiology; middle aged; otitis media; pathogenicity; pneumococcal infection; preschool child; prevalence; serotype; Streptococcus pneumoniae; young adult; Adolescent; Adult; Amoxicillin; Anti-Bacterial Agents; Child; Child, Preschool; Drug Resistance, Bacterial; Female; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Middle Aged; Multilocus Sequence Typing; Otitis Media; Penicillins; Pneumococcal Infections; Pneumococcal Vaccines; Prevalence; Serogroup; Serotyping; Streptococcus pneumoniae; Sulfamethoxazole; Taiwan; Trimethoprim; Vaccines, Conjugate; Young Adult
Publisher
Elsevier Ltd
Type
journal article