Ability of pneumococcal serotypes and clones to cause acute otitis media: implications for the prevention of otitis media by conjugate vaccines.
The relative abilities of pneumococcal serotypes and strains (clones) to cause acute otitis media (AOM) were investigated by comparing the serotypes and genotypes of pneumococci recovered from cases of AOM (n = 149) in children <2 years of age with those from nasopharyngeal carriage (n = 288) in age-matched controls from the same region. The odds ratio (OR) for association of pooled vaccine serotypes with AOM was found to be slightly elevated over unity, although this was not significantly different from that of pooled nonvaccine or vaccine-related serotypes. Comparing individual serotypes, 19F and 23F had 2- to 2.5-fold higher ORs, although these were not markedly different from the ORs of nonvaccine serotypes. None of the major clones had an OR that was significantly greater than the average, and the differences in ORs among serotypes and clones were much less than those for invasive disease, suggesting little variation in their ability to cause AOM. We conclude that serotype replacement may reduce the long-term efficacy of these vaccines against AOM.
Hanage
William P
WP
Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, St. Mary's Hospital, London W2 1PG, United Kingdom.
Auranen
Kari
K
Syrjänen
Ritva
R
Herva
Elja
E
Mäkelä
P Helena
PH
Kilpi
Terhi
T
Spratt
Brian G
BG
D000208:Acute Disease; D000483:Alleles; D002353:Carrier State / Q000382:microbiology*; D002675:Child, Preschool; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000032:analysis; D006801:Humans; D007223:Infant; D009305:Nasopharynx / Q000382:microbiology*; D010033:Otitis Media / Q000382:microbiology* / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000382:microbiology; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D016133:Polymerase Chain Reaction; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000235:genetics* / Q000472:pathogenicity; D018074:Vaccines, Conjugate / Q000008:administration & dosage; D014774:Virulence
D004269:DNA, Bacterial; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate