title: Effect of pneumococcal conjugate vaccination on nasopharyngeal carriage in children with early onset of acute otitis media - a randomized controlled trial.
abstract: CONCLUSIONS
  Although children vaccinated with heptavalent pneumococcal conjugate vaccine (PCV) had fewer episodes of acute otitis media (AOM), this trial was unable to prove a simultaneous decrease in nasopharyngeal carriage.
  
  
  OBJECTIVE
  Carriage rates of AOM pathogens in the nasopharynx are high among children, and colonization is the first step towards infection. The possible impact of PCV on carriage is therefore of interest, particularly in children with recurrent AOM. The aims of this study were to examine the effect of heptavalent PCV on carriage of AOM pathogens in children at high risk of developing recurrent disease, and to monitor carriage of resistant pathogens in vaccinated and unvaccinated children.
  
  
  METHODS
  A total of 109 children with an onset of AOM before 6 months of age, 89 of whom developed recurrent disease, were enrolled in a trial. Fifty-two children were vaccinated and all were closely monitored for 3 years.
  
  
  RESULTS
  There was no difference statistically between vaccinated children and controls concerning the carriage of any of the major AOM pathogens. There was evidence of within-child clustering for S. pneumoniae (p = 0.002) and H. influenzae (p < 0.001), indicating that children continued to carry either species over time. Resistance rates were generally low and comparable with national levels.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital , Lund , Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Gisselsson-Solén
authors.forename: Gunnel
authors.initials: G
authors.lastname: Henriksson
authors.forename: Ann
authors.initials: A
authors.lastname: Hermansson
authors.forename: Asa
authors.initials: A
authors.lastname: Melhus
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D002353:Carrier State / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007223:Infant; D008297:Male; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D009305:Nasopharynx / Q000382:microbiology*; D010033:Otitis Media / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines; D012008:Recurrence; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D013548:Sweden
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines
keywords: Haemophilus influenzae; Moraxella catarrhalis; PCV; Recurrent acute otitis media; Streptococcus pneumoniae