title: Acute otitis media otopathogens during 2008 to 2010 in Rochester, New York.
abstract: BACKGROUND
  The otopathogen distribution colonizing the nasopharynx (NP) and causing acute otitis media (AOM) is in flux following the introduction of pneumococcal conjugate vaccine 7 (PCV7) and will continue to change.
  
  
  METHODS
  Two hundred seventy-seven children were followed prospectively; tympanocentesis was performed during AOM and 208 NP samples were collected to compare with middle ear fluid (MEF) isolates. Eight hundred sixty-three NP samples were collected at 7 healthy visits between 6 and 30 months of age. All children received PCV7 until April 2010 when it was substituted by PCV13. Multilocus sequence typing was used to speciate Streptococcus pneumoniae.
  
  
  RESULTS
  The distribution of otopathogens in the MEF during the study time frame was stable. PCV7 serotypes of pneumococci were virtually absent. The frequency of isolation of S. pneumoniae was 26-36% compared with 28-34% for nontypeable Haemophilus influenzae. Moraxella catarrhalis isolation was less common, 7-18%. The proportion of S. pneumoniae that were penicillin nonsusceptible was stable during the 3 years, 40-52%. All M. catarrhalis and 34% of nontypeable H. influenzae were β-lactamase producing. NP isolates of otopathogens at onset of AOM included the isolate from the MEF and was dissimilar from the distribution at times of health. Sequence types 320 and 199 of S. pneumoniae expressing serotypes 19A and 15 most often caused AOM.
  
  
  CONCLUSIONS
  The otopathogen distribution, antibiotic susceptibility and the diversity of strains within the S. pneumoniae species during 2008 through late 2010 were stable. NP isolation of otopathogens at onset of AOM better reflected, albeit incompletely, likely MEF isolates compared with NP isolates at times of health.
authors.affiliation: Legacy Pediatrics, 1815 S. Clinton Avenue, Rochester NY 14618.
authors.forename: Janet R
authors.initials: JR
authors.lastname: Casey
authors.affiliation: Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, Rochester, NY 14621.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Kaur
authors.affiliation: Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, Rochester, NY 14621.
authors.forename: Victoria C
authors.initials: VC
authors.lastname: Friedel
authors.affiliation: Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, Rochester, NY 14621.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Pichichero
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004432:Ear, Middle / Q000382:microbiology; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D058885:Multilocus Sequence Typing; D009518:New York / Q000453:epidemiology; D010033:Otitis Media / Q000453:epidemiology* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases