title: Assessment of the protective effect of pneumococcal vaccination in preventing meningitis after cochlear implantation.
abstract: OBJECTIVE
  To examine if a 23-valent pneumococcal capsular polysaccharide vaccine (PPV23) reduces the risk of meningitis in healthy rats after cochlear implantation.
  
  
  METHODS
  Interventional animal study.
  
  
  METHODS
  Thirty-six rats (18 immunized and 18 unimmunized) received cochlear implantations and were then infected with Streptococcus pneumoniae via 3 different routes (hematogenous, middle ear, and inner ear) in numbers sufficient to induce meningitis.
  
  
  RESULTS
  The rats with implants that received PPV23 were protected from meningitis when the bacteria were delivered via the hematogenous and middle-ear routes (Fisher exact test P<.05). However, the protective effect of the vaccine in the rats with implants was only moderate when the bacteria were inoculated directly into the inner ear.
  
  
  CONCLUSIONS
  Our animal model clearly demonstrates that immunization can protect healthy rats with a cochlear implant from meningitis caused by a vaccine-covered serotype. This finding supports the notion that all current and future implant recipients should be vaccinated against S pneumoniae.
authors.affiliation: Bionic Ear Institute, Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisbourne St, East Melbourne, Victoria 3002, Australia. bwei@bionicear.org
authors.forename: Benjamin P C
authors.initials: BP
authors.lastname: Wei
authors.forename: Roy M
authors.initials: RM
authors.lastname: Robins-Browne
authors.forename: Robert K
authors.initials: RK
authors.lastname: Shepherd
authors.forename: Kristy
authors.initials: K
authors.lastname: Azzopardi
authors.forename: Graeme M
authors.initials: GM
authors.lastname: Clark
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: O'Leary
mesh_terms: D000818:Animals; D000907:Antibodies, Bacterial / Q000032:analysis; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants / Q000009:adverse effects* / Q000382:microbiology; D004195:Disease Models, Animal; D007124:Immunoenzyme Techniques; D008578:Meninges / Q000382:microbiology / Q000473:pathology; D008586:Meningitis, Pneumococcal / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D010784:Photomicrography; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013296:Streptococcus pneumoniae / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D016896:Treatment Outcome; D014611:Vaccination / Q000379:methods*
chemical_list: D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines