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Substantial reduction of antibiotic-non-susceptible pneumococcal otitis media following PCV7/PCV13 sequential introduction.
J Antimicrob Chemother. 2020 10 01; 75(10):3038-3045.JA

Abstract

BACKGROUND

In the pre-pneumococcal conjugated vaccines (PCVs) era, serotypes included in the 7/13-valent PCVs (PCV7/PCV13) caused most pneumococcal otitis media (OM) and antibiotic-non-susceptible pneumococcal OM (ANSP-OM) episodes. In southern Israel, sequential PCV7/PCV13 introduction resulted in >90% reduction of vaccine-serotype OM.

OBJECTIVES

We assessed the dynamics of ANSP-OM necessitating middle ear fluid culture following PCV7/PCV13 sequential introduction in young children.

METHODS

This was a prospective, population-based, active surveillance. All episodes in children <3 years old, during 2004-16, were included. Two subperiods were defined: (i) pre-PCV: 2004-08; and (ii) PCV13: 2014-16. ANSP was defined for the following antibiotics: penicillin (MIC ≥0.1 mg/L and ≥1.0 mg/L), macrolide, tetracycline, clindamycin, ceftriaxone, trimethoprim/sulfamethoxazole and chloramphenicol. MDR was defined as ANSP for ≥3 classes.

RESULTS

Overall, 2270 pneumococcal OM episodes were identified. Annual overall pneumococcal, PCV13 and non-PCV13 serotype OM incidence declined by 86%, 97% and 33%, respectively, comparing pre-PCV with the PCV13 period. During 2004-08, 95% of ANSP was observed in vaccine serotypes. Incidence of penicillin (MIC ≥0.1 mg/L and ≥1.0 mg/L), macrolide, tetracycline, clindamycin, ceftriaxone and multidrug ANSP-OM declined by >90% in the PCV13 period. Rates of trimethoprim/sulfamethoxazole and chloramphenicol ANSP-OM declined by 85% and 79%, respectively. The proportions of ANSP of all pneumococcal isolates declined by ∼70% for penicillin, ceftriaxone and erythromycin; 53% for tetracycline; and 55% for MDR, versus no significant reductions observed for chloramphenicol, trimethoprim/sulfamethoxazole and clindamycin.

CONCLUSIONS

PCV7/PCV13 sequential introduction resulted in rapid and substantial ANSP-OM reduction, in parallel with the near disappearance of PCV13-serotype OM and no increase in replacement disease.

Authors+Show Affiliations

The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32946586

Citation

Ben-Shimol, Shalom, et al. "Substantial Reduction of Antibiotic-non-susceptible Pneumococcal Otitis Media Following PCV7/PCV13 Sequential Introduction." The Journal of Antimicrobial Chemotherapy, vol. 75, no. 10, 2020, pp. 3038-3045.
Ben-Shimol S, Givon-Lavi N, Greenberg D, et al. Substantial reduction of antibiotic-non-susceptible pneumococcal otitis media following PCV7/PCV13 sequential introduction. J Antimicrob Chemother. 2020;75(10):3038-3045.
Ben-Shimol, S., Givon-Lavi, N., Greenberg, D., van der Beek, B. A., Leibovitz, E., & Dagan, R. (2020). Substantial reduction of antibiotic-non-susceptible pneumococcal otitis media following PCV7/PCV13 sequential introduction. The Journal of Antimicrobial Chemotherapy, 75(10), 3038-3045. https://doi.org/10.1093/jac/dkaa263
Ben-Shimol S, et al. Substantial Reduction of Antibiotic-non-susceptible Pneumococcal Otitis Media Following PCV7/PCV13 Sequential Introduction. J Antimicrob Chemother. 2020 10 1;75(10):3038-3045. PubMed PMID: 32946586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Substantial reduction of antibiotic-non-susceptible pneumococcal otitis media following PCV7/PCV13 sequential introduction. AU - Ben-Shimol,Shalom, AU - Givon-Lavi,Noga, AU - Greenberg,David, AU - van der Beek,Bart Adriaan, AU - Leibovitz,Eugene, AU - Dagan,Ron, PY - 2020/03/25/received PY - 2020/05/11/revised PY - 2020/05/14/accepted PY - 2020/9/18/entrez PY - 2020/9/19/pubmed PY - 2021/6/25/medline SP - 3038 EP - 3045 JF - The Journal of antimicrobial chemotherapy JO - J Antimicrob Chemother VL - 75 IS - 10 N2 - BACKGROUND: In the pre-pneumococcal conjugated vaccines (PCVs) era, serotypes included in the 7/13-valent PCVs (PCV7/PCV13) caused most pneumococcal otitis media (OM) and antibiotic-non-susceptible pneumococcal OM (ANSP-OM) episodes. In southern Israel, sequential PCV7/PCV13 introduction resulted in >90% reduction of vaccine-serotype OM. OBJECTIVES: We assessed the dynamics of ANSP-OM necessitating middle ear fluid culture following PCV7/PCV13 sequential introduction in young children. METHODS: This was a prospective, population-based, active surveillance. All episodes in children <3 years old, during 2004-16, were included. Two subperiods were defined: (i) pre-PCV: 2004-08; and (ii) PCV13: 2014-16. ANSP was defined for the following antibiotics: penicillin (MIC ≥0.1 mg/L and ≥1.0 mg/L), macrolide, tetracycline, clindamycin, ceftriaxone, trimethoprim/sulfamethoxazole and chloramphenicol. MDR was defined as ANSP for ≥3 classes. RESULTS: Overall, 2270 pneumococcal OM episodes were identified. Annual overall pneumococcal, PCV13 and non-PCV13 serotype OM incidence declined by 86%, 97% and 33%, respectively, comparing pre-PCV with the PCV13 period. During 2004-08, 95% of ANSP was observed in vaccine serotypes. Incidence of penicillin (MIC ≥0.1 mg/L and ≥1.0 mg/L), macrolide, tetracycline, clindamycin, ceftriaxone and multidrug ANSP-OM declined by >90% in the PCV13 period. Rates of trimethoprim/sulfamethoxazole and chloramphenicol ANSP-OM declined by 85% and 79%, respectively. The proportions of ANSP of all pneumococcal isolates declined by ∼70% for penicillin, ceftriaxone and erythromycin; 53% for tetracycline; and 55% for MDR, versus no significant reductions observed for chloramphenicol, trimethoprim/sulfamethoxazole and clindamycin. CONCLUSIONS: PCV7/PCV13 sequential introduction resulted in rapid and substantial ANSP-OM reduction, in parallel with the near disappearance of PCV13-serotype OM and no increase in replacement disease. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/32946586/Substantial_reduction_of_antibiotic_non_susceptible_pneumococcal_otitis_media_following_PCV7/PCV13_sequential_introduction_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkaa263 DB - PRIME DP - Unbound Medicine ER -