title: Prevention of early episodes of otitis media by pneumococcal vaccines might reduce progression to complex disease.
abstract: Otitis media is a common childhood infection of the middle ear and a major cause of morbidity. This multifactorial disease manifests as a spectrum of clinical syndromes from uncomplicated acute otitis media to more complex recurrent and chronic cases (frequently polymicrobial), with the major pathogens involved being Streptococcus pneumoniae and non-typeable Haemophilus influenzae. Pneumococcal conjugate vaccines (PCVs) target only a few serotypes that cause otitis media; however, results from studies suggest that existing PCVs can prevent early episodes of disease associated with vaccine serotypes, resulting in a reduction of subsequent complex cases caused by non-vaccine serotypes and other otopathogens, which contribute considerably to the disease burden. In this Review, we discuss the role of pneumococcus in the disease continuum and assess clinical evidence showing the effect of prevention of early episodes on the complex interplay between bacterial species implicated in otitis media.
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: rdagan@bgu.ac.il.
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.affiliation: Boston University School of Medicine, Boston, MA, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Pelton
authors.affiliation: Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bakaletz
authors.affiliation: Université Paris Est, IMRB-GRC GEMINI, and Unité Court Séjour, Petits Nourrissons, Centre Hospitalier Intercommunal de Créteil, Paris, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000208:Acute Disease; D018450:Disease Progression; D006801:Humans; D010033:Otitis Media / Q000517:prevention & control*; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D013296:Streptococcus pneumoniae / Q000276:immunology* / Q000472:pathogenicity; D018074:Vaccines, Conjugate
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate