title: New Pneumococcal Carriage Acquired in Association with Acute Respiratory Infection Is Prone to Cause Otitis Media.
abstract: For considering vaccine-prevention of pneumococcal acute otitis media (PncAOM), relationships between pneumococcal carriage, respiratory infection and PncAOM need to be understood. We analyzed nasopharyngeal samples collected from 329 unvaccinated Finnish children aged 2-24 months at scheduled visits and at visits during respiratory infection in 1994-97. We assessed temporal associations of respiratory infection with pneumococcal acquisition and whether PncAOM hazard depends on the relative timing of acquisition and the infection onset. The data comprised 607 person-years of risk-time for acquisition, 245 person-months of concurrent respiratory infection and carriage, and 119 episodes of PncAOM. The acquisition hazard was 3-fold in the month preceding respiratory sickness (hazard ratio, HR 3.5, 90% credible interval CI 2.9, 4.1) as compared to acquisition in healthy children. Moreover, the PncAOM hazard was markedly higher (HR 3.7, 90% CI 2.4, 5.3) during the first month of carriage acquired around the acute phase of respiratory infection (between 1 month before and 1 week after the sickness onset), as compared to carriage acquired later during sickness. The high proportion (76%) of PncAOM events occurring within 1 month of acquisition was due to frequent acquisition being associated with respiratory infection as well as the susceptibility of such acquisition to cause otitis media.
authors.affiliation: Department of Health Protection, National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland.|Department of Mathematics and Statistics, 20014 University of Turku, Turku, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Auranen
authors.affiliation: Department of Health Protection, National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland.|Department of Health Protection, National Institute for Health and Welfare, Finn-Medi I, Biokatu 6, 33520 Tampere, Finland.
authors.forename: Ritva
authors.initials: R
authors.lastname: Syrjänen
authors.affiliation: Department of Health Protection, National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland.
authors.forename: Tuija
authors.initials: T
authors.lastname: Leino
authors.affiliation: Department of Health Protection, National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland.
authors.forename: Terhi
authors.initials: T
authors.lastname: Kilpi
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002353:Carrier State / Q000276:immunology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010033:Otitis Media / Q000209:etiology* / Q000382:microbiology* / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000150:complications / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D012141:Respiratory Tract Infections / Q000150:complications / Q000382:microbiology / Q000517:prevention & control; D013296:Streptococcus pneumoniae / Q000472:pathogenicity
chemical_list: D022242:Pneumococcal Vaccines