Reduced middle ear infection with non-typeable Haemophilus influenzae, but not Streptococcus pneumoniae, after transition to 10-valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine

BMC Pediatrics

Peter Stanley Morris¹  Heidi Smith-Vaughan²  Mark Chatfield²  Ross Andrews²  Jemima Beissbarth²  Vanya Hampton²  Kim Hare²  Christine Wigger²  Amanda Jane Leach² 

[1] Royal Darwin Hospital, Darwin, Northern Territory, Australia;Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia

关键词: Risk factors;    Surveillance;    Prevalence;    Pneumococcal vaccines;    Indigenous;    child;    Otitis media;    Nontypeable Haemophilus influenzae;    Streptococcus pneumoniae;    Nasopharynx;   

Others  :  1234553
DOI  :  10.1186/s12887-015-0483-8

 received in 2014-12-26, accepted in 2015-10-09,  发布年份 2015

【 摘 要 】

Background

In October 2009, 7-valent pneumococcal conjugate vaccine (PCV7: Prevenar ^TMPfizer) was replaced in the Northern Territory childhood vaccination schedule by 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10; Synflorix™ GlaxoSmithKline Vaccines). This analysis aims to determine whether the reduced prevalence of suppurative otitis media measured in the PHiD-CV10 era was associated with changes in nasopharyngeal (NP) carriage and middle ear discharge (ED) microbiology in vaccinated Indigenous children.

Methods

Swabs of the NP and ED were collected in remote Indigenous communities between September 2008 and December 2012. Swabs were cultured using standardised methods for otitis media pathogens. Children less than 3 years of age and having received a primary course of 2 or more doses of one PCV formulation and not more than one dose of another PCV formulation were included in the primary analysis; children with non-mixed single formulation PCV schedules were also compared.

Results

NP swabs were obtained from 421 of 444 (95 %) children in the PCV7 group and 443 of 451 (98 %) children in the PHiD-CV10 group. Non-mixed PCV schedules were received by 333 (79 %) and 315 (71 %) children, respectively. Pneumococcal (Spn) NP carriage was 76 % and 82 %, and non-typeable Haemophilus influenzae (NTHi) carriage was 68 % and 73 %, respectively. ED was obtained from 60 children (85 perforations) in the PCV7 group and from 47 children (59 perforations) in the PHiD-CV10 group. Data from bilateral perforations were combined. Spn was cultured from 25 % and 18 %, respectively, and NTHi was cultured from 61 % and 34 % respectively (p = 0.008).

Conclusions

The observed reduction in the prevalence of suppurative OM in this population was not associated with reduced NP carriage of OM pathogens. The prevalence of NTHi-infected ED was lower in PHiD-CV10 vaccinated children compared to PCV7 vaccinated children. Changes in clinical severity may be explained by the action of PHiD-CV10 on NTHi infection in the middle ear. Randomised controlled trials are needed to answer this question.

【 授权许可】

   
2015 Leach et al.

【 图 表 】

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【 参考文献 】

• [1]Leach AJ, Wigger C, Andrews R, Chatfield M, Smith-Vaughan H, Morris PS. Otitis media in children vaccinated during consecutive 7-valent or 10-valent pneumococcal conjugate vaccination schedules. BMC Pediatr. 2014; 14(1):200. BioMed Central Full Text
• [2]Leach AJ, Morris PS. The burden and outcome of respiratory tract infection in Australian and aboriginal children. PediatrInfectDisJ. 2007; 26(10 Suppl):S4-S7.
• [3]Morris PS, Leach AJ, Halpin S, Mellon G, Gadil G, Wigger C, Mackenzie G, Wilson C, Gadil E, Torzillo P. An overview of acute otitis media in Australian Aboriginal children living in remote communities. Vaccine. 2007; 25(13):2389-2393.
• [4]Smith-Vaughan HC, Binks MJ, Marsh RL, Kaestli M, Ward L, Hare KM, Pizzutto SJ, Thornton RB, Morris PS, Leach AJ. Dominance of Haemophilus influenzae in ear discharge from Indigenous Australian children with acute otitis media with tympanic membrane perforation. BMC Ear Nose Throat Disord. 2013; 13(1):12. BioMed Central Full Text
• [5]Deloria Knoll M, Park DE, Johnson TS, Chandir S, Nonyane BA, Conklin L, Fleming-Dutra KE, Loo JD, Goldblatt D, Whitney CG et al.. Systematic review of the effect of pneumococcal conjugate vaccine dosing schedules on immunogenicity. Pediatr Infect Dis J. 2014; 33 Suppl 2:S119-129.
• [6]Prymula R, Peeters P, Chrobok V, Kriz P, Novakova E, Kaliskova E, Kohl I, Lommel P, Poolman J, Prieels JP et al.. Pneumococcal capsular polysaccharides conjugated to protein D for prevention of acute otitis media caused by both Streptococcus pneumoniae and non-typable Haemophilus influenzae: a randomised double-blind efficacy study. Lancet. 2006; 367(9512):740-748.
• [7]Prymula R, Hanovcova I, Splino M, Kriz P, Motlova J, Lebedova V, Lommel P, Kaliskova E, Pascal T, Borys D et al.. Impact of the 10-valent pneumococcal non-typeable Haemophilus influenzae Protein D conjugate vaccine (PHiD-CV) on bacterial nasopharyngeal carriage. Vaccine. 2011; 29(10):1959-1967.
• [8]Prymula R, Kriz P, Kaliskova E, Pascal T, Poolman J, Schuerman L. Effect of vaccination with pneumococcal capsular polysaccharides conjugated to Haemophilus influenzae-derived protein D on nasopharyngeal carriage of Streptococcus pneumoniae and H. influenzae in children under 2 years of age. Vaccine. 2009; 28(1):71-78.
• [9]Tregnaghi MW, Saez-Llorens X, Lopez P, Abate H, Smith E, Posleman A, Calvo A, Wong D, Cortes-Barbosa C, Ceballos A et al.. Efficacy of pneumococcal nontypable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in young Latin American children: A double-blind randomized controlled trial. PLoS medicine. 2014; 11(6):e1001657.
• [10]Leach A, Wood Y, Gadil E, Stubbs E, Morris P. Topical ciprofloxin versus topical framycetin-gramicidin-dexamethasone in Australian aboriginal children with recently treated chronic suppurative otitis media: a randomized controlled trial. PediatrInfectDisJ. 2008; 27(8):692-698.
• [11]Satzke C, Turner P, Virolainen-Julkunen A, Adrian PV, Antonio M, Hare KM, Henao-Restrepo AM, Leach AJ, Klugman KP, Porter BD et al.. Standard method for detecting upper respiratory carriage of Streptococcus pneumoniae: Updated recommendations from the World Health Organization Pneumococcal Carriage Working Group. Vaccine. 2013; 32(1):165-179.
• [12]Beissbarth J, Binks M, Scarff K, Marsh R, Nosworthy E, Chang A, Leach A, Smith-Vaughan H. Non-typeable Haemophilus influenzae and H. haemolyticus identification in the Northern Territory of Australia. Australian Otitis Media Meeting (OMOZ), Melbourne; 2014.
• [13]Bell SM. The CDS disc method of antibiotic sensitivity testing (calibrated dichotomous sensitivity test). Pathology. 1975; 7(4 Suppl):Suppl-48.
• [14]Stubbs E, Hare K, Wilson C, Morris P, Leach AJ. Streptococcus pneumoniae and noncapsular Haemophilus influenzae nasal carriage and hand contamination in children: a comparison of two populations at risk of otitis media. Pediatr Infect Dis J. 2005; 24(5):423-428.
• [15]Morris PS, Leach AJ, Silberberg P, Mellon G, Wilson C, Hamilton E, Beissbarth J. Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey. BMCPediatr. 2005; 5:27-37.
• [16]Stata Statistical Software: Release 12 College Station. StataCorp LP, TX; 2011.
• [17]Bar-Zeev SJ, Kruske SG, Barclay LM, Bar-Zeev N, Kildea SV. Adherence to management guidelines for growth faltering and anaemia in remote dwelling Australian Aboriginal infants and barriers to health service delivery. BMC Health Serv Res. 2013; 13:250. BioMed Central Full Text
• [18]Hussain SQ, Ashraf M, Wani JG, Ahmed J. Low Hemoglobin Level a Risk Factor for Acute Lower Respiratory Tract Infections (ALRTI) in Children. J Clin Diagn Res. 2014; 8(4):c01-03.
• [19]van den Bergh MR, Spijkerman J, Swinnen KM, Francois NA, Pascal TG, Borys D, Schuerman L, Ijzerman EP, Bruin JP, van der Ende A et al.. Effects of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D-conjugate vaccine on nasopharyngeal bacterial colonization in young children: a randomized controlled trial. Clin Infect Dis. 2013; 56(3):e30-39.
• [20]Hammitt LL, Akech DO, Morpeth SC, Karani A, Kihuha N, Nyongesa S, Bwanaali T, Mumbo E, Kamau T, Sharif SK et al.. Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi, Kenya: findings from cross-sectional carriage studies. Lancet Glob Health. 2014; 2(7):e397-405.
• [21]Johnson RW, McGillivary G, Denoel P, Poolman J, Bakaletz LO. Abrogation of nontypeable Haemophilus influenzae protein D function reduces phosphorylcholine decoration, adherence to airway epithelial cells, and fitness in a chinchilla model of otitis media. Vaccine. 2011; 29(6):1211-1221.
• [22]Smith-Vaughan HC, Chang AB, Sarovich DS, Marsh RL, Grimwood K, Leach AJ, Morris PS, Price EP. Absence of an important vaccine and diagnostic target in carriage- and disease-related nontypeable Haemophilus influenzae. Clin Vaccine Immunol. 2013; 21(2):250-252.
• [23]Mackenzie G, Leach A, Carapetis J, Fisher J, Morris P. Epidemiology of nasopharyngeal carriage of respiratory bacterial pathogens in children and adults: cross-sectional surveys in a population with high rates of pneumococcal disease. BMC Infect Dis. 2010; 10(1):304-314. BioMed Central Full Text
• [24]Leach AJ, Morris PS, McCallum GB, Wilson CA, Stubbs L, Beissbarth J, Jacups S, Hare K, Smith-Vaughan HC. Emerging pneumococcal carriage serotypes in a high-risk population receiving 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001. BMCInfectDis. 2009; 9(1):121.
• [25]Ben-Shimol S, Givon-Lavi N, Leibovitz E, Raiz S, Greenberg D, Dagan R. Near elimination of otitis media caused by the PCV13 serotypes in Southern Israel shortly after sequential introduction of PCV7/PCV13. Clin Infect Dis. 2014.
• [26]van der Linden M, Imohl M, Busse A, Rose M, Adam D. Bacterial spectrum of spontaneously ruptured otitis media in the era of pneumococcal conjugate vaccination in Germany. Eur J Pediatr. 2014.
• [27]Smith-Vaughan H, Byun R, Nadkarni M, Jacques NA, Hunter N, Halpin S, Morris PS, Leach AJ. Measuring nasal bacterial load and its association with otitis media. BMC Ear Nose Throat Disord. 2006; 6:10-19. BioMed Central Full Text
• [28]Poetker DM, Lindstrom DR, Edmiston CE, Krepel CJ, Link TR, Kerschner JE. Microbiology of middle ear effusions from 292 patients undergoing tympanostomy tube placement for middle ear disease. Int J Pediatr Otorhinolaryngol. 2005; 69(6):799-804.
• [29]Wiertsema SP, Kirkham LA, Corscadden KJ, Mowe EN, Bowman JM, Jacoby P, Francis R, Vijayasekaran S, Coates HL, Rileyc TV et al.. Predominance of nontypeable Haemophilus influenzae in children with otitis media following introduction of a 3+0 pneumococcal conjugate vaccine schedule. Vaccine. 2011; 29:5163-5170.
• [30]Mills N, Best EJ, Murdoch D, Souter M, Neeff M, Anderson T, et al. What is behind the ear drum? The microbiology of otitis media and the nasopharyngeal flora in children in the era of pneumococcal vaccination. J Paediatr Child Health. 2014.
• [31]Pumarola F, Mares J, Losada I, Minguella I, Moraga F, Tarrago D, Aguilera U, Casanovas JM, Gadea G, Trias E et al.. Microbiology of bacteria causing recurrent acute otitis media (AOM) and AOM treatment failure in young children in Spain: shifting pathogens in the post-pneumococcal conjugate vaccination era. Int J Pediatr Otorhinolaryngol. 2013; 77(8):1231-1236.