중이염 환아의 이루에서 분리된 폐구균의 혈청형 분포(2001-2006)
Serotype Distribution of Pneumococcus Isolated from the Ear Discharge in Children with Otitis Media in 2001-2006
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초록
Purpose : Better understanding of the epidemiology of Streptococcus pneumoniae affects preventive and therapeutic strategies for children with otitis media. This study was undertaken to examine the prevalence of pneumococcal serotypes causing otitis media in children. Methods : Pneumococcal isolates obtained from the ear discharge of children with otitis media between January 2001 and December 2006 were characterized by serotyping and antibiotic susceptibility testing. Results : There were 54 pneumococcal isolates from 54 children with otitis media. The median age of patients was 13 months, and the proportion of children <5 years old was 81%. The predominant serotypes, in order of decreasing frequency, were 19A (44%), 19F (28%), 6B (7%), 6A (4%), 9V (4%), and 1 (4%); 23 isolates (43%) belonged to types included in the heptavalent pneumococcal conjugate vaccine (PCV7). The proportion of serotype 19A and 19F accounted for 72% of overall pneumococcal isolates, which accounted for 84% of pneumococcal isolates from otorrhea of children <5 years old (vs 20% in children ≥5 years old, P<0.001). All serotypes isolated from 3 vaccinees of PCV7 were 19A. There was no significant diminution in otitis media caused by pneumococcal vaccine serotypes after the introduction of PCV7. The frequency of nonsusceptibility to penicillin, erythromycin, and trimethoprim-sulfamethoxazole was higher in serotype 19A than in other non-vaccine serotypes, respectively. The frequency of multiple drug resistance was 96% in serotype 19A, compared with 29% in other non-vaccine serotypes (P=0.001). Conclus ion : 19A was the most common pneumococcal serotype causing otitis media and represented a large proportion of strains with multiple drug resistance in children younger than 5 years of age. (Korean J Pediatr Infect Dis 2008;15:44-50)
Abstract
Purpose : Better understanding of the epidemiology of Streptococcus pneumoniae affects preventive and therapeutic strategies for children with otitis media. This study was undertaken to examine the prevalence of pneumococcal serotypes causing otitis media in children. Methods : Pneumococcal isolates obtained from the ear discharge of children with otitis media between January 2001 and December 2006 were characterized by serotyping and antibiotic susceptibility testing. Results : There were 54 pneumococcal isolates from 54 children with otitis media. The median age of patients was 13 months, and the proportion of children <5 years old was 81%. The predominant serotypes, in order of decreasing frequency, were 19A (44%), 19F (28%), 6B (7%), 6A (4%), 9V (4%), and 1 (4%); 23 isolates (43%) belonged to types included in the heptavalent pneumococcal conjugate vaccine (PCV7). The proportion of serotype 19A and 19F accounted for 72% of overall pneumococcal isolates, which accounted for 84% of pneumococcal isolates from otorrhea of children <5 years old (vs 20% in children ≥5 years old, P<0.001). All serotypes isolated from 3 vaccinees of PCV7 were 19A. There was no significant diminution in otitis media caused by pneumococcal vaccine serotypes after the introduction of PCV7. The frequency of nonsusceptibility to penicillin, erythromycin, and trimethoprim-sulfamethoxazole was higher in serotype 19A than in other non-vaccine serotypes, respectively. The frequency of multiple drug resistance was 96% in serotype 19A, compared with 29% in other non-vaccine serotypes (P=0.001). Conclus ion : 19A was the most common pneumococcal serotype causing otitis media and represented a large proportion of strains with multiple drug resistance in children younger than 5 years of age. (Korean J Pediatr Infect Dis 2008;15:44-50)
참고문헌 (36)
- Block SL, "Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media", Pediatr Infect Dis J, 16, pp.449~456 (1997)
- World Health Organization, "Pneumococcal vaccines. WHO position paper", Wkly Epidemiol Rec, 74, pp.177~183 (1999)
- Overturf GD, "Committee on Infectious Diseases. Technical report:prevention of pneumococcal infections, including the use of pneumococcal conjugate and polysaccharide vaccines and antibiotic prophylaxis", Pediatrics, 106, pp.367~376 (2000)
- Feikin DR, "Historical changes in pneumococcal serogroup distribution: implications for the era of pneumococcal conjugate vaccines", Clin Infect Dis, 35, pp.547~555 (2002)
- Black S, "Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group", Pediatr Infect Dis J, 19, pp.187~195 (2000)
- Whitney CG, "Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine", N Engl J Med, 348, pp.1737~1746 (2003)
- Dagan R, "Reduction of nasopharyngeal carriage of pneumococci during the second year of life by a heptavalent conjugate pneumococcal vaccine", J Infect Dis, 174, pp.1271~1278 (1996)
- Ghaffar F, "Effect of the 7-valent pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae in the first 2 years of life", Clin Infect Dis, 39, pp.930~938 (2004)
- Eskola J, "of a pneumococcal conjugate vaccine against acute otitis media", N Engl J Med, 344, pp.403~409 (2001)
- Hausdorff WP, "Multinational study of pneumococcal serotypes causing acute otitis media in children", Pediatr Infect Dis J, 21, pp.1008~1016 (2002)
- Mühlemann K, "Nationwide surveillance of nasopharyngeal Streptococcus pneumoniae isolates from children with respiratory infection, Switzerland, 1998-1999", J Infect Dis, 187, pp.589~596 (2003)
- van Belkum A, "Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children", Lancet, 363, pp.1871~1872 (2004)
- Dagan R, "Acute otitis media caused by antibioticresistant Streptococcus pneumoniae in southern Israel: implication for immunizing with conjugate vaccines", J Infect Dis, 181, pp.1322~1329 (2000)
- Yoon TH, "Morphometric studies of the continuum of otitis media", Ann Otol Rhinol Laryngol Suppl, 148, pp.23~27 (1990)
- Rovers MM, "Otitis media", Lancet, 363, pp.465~473 (2004)
- Straetemans M, "A comprehensive model for the aetiology of otitis media with effusion", Med Hypotheses, 57, pp.784~791 (2001)
- Tonnaer EL, "Bacterial otitis media: a new non-invasive rat model", Vaccine, 21, pp.4539~4544 (2003)
- Kemaloğlu YK, "Otitis media with effusion and craniofacial analysis-II: "Mastoid-middle ear-eustachian tube system" in children with secretory otitis media", Int J Pediatr Otorhinolaryngol, 32, pp.69~76 (1995)
- Jero J, "Bacteriological findings and persistence of middle ear effusion in otitis media with effusion", Acta Otolaryngol Suppl, 529, pp.22-~26 (1997)
- Ruuskanen O, "Acute otitis media and respiratory virus infections", Pediatr Infect Dis J, 8, pp.94~99 (1989)
- Heikkinen T, "Prevalence of various respiratory viruses in the middle ear during acute otitis media", N Engl J Med, 340, pp.260~264 (1999)
- Belshe RB, "Current status of live attenuated influenza virus vaccine in the US", Virus Res, 103, pp.177~185 (2004)
- O'Brien KL, "Immunologic priming of young children by pneumococcal glycoprotein conjugate, but not polysaccharide, vaccines", Pediatr Infect Dis J, 15, pp.425~430 (1996)
- Kilpi T, "Protective efficacy of a second pneumococcal conjugate vaccine against pneumococcal acute otitis media in infants and children: randomized, controlled trial of a 7-valent pneumococcal polysaccharide-meningococcal outer membrane protein complex conjugate vaccine in 1666 children", Clin Infect Dis, 37, pp.1155~1164 (2003)
- McEllistrem MC, "Acute otitis media due to penicillin-nonsusceptible Streptococcus pneumoniae before and after the introduction of the pneumococcal conjugate vaccine", Clin Infect Dis, 40, pp.1738~1744 (2005)
- Pichichero ME, "Emergence of a multiresistant serotype 19A pneumococcal strain not included in the 7-valent conjugate vaccine as an otopathogen in children", JAMA, 298, pp.1772~1778 (2007)
- as AP, "Expression and characterization of cholera toxin B-pneumococcal surface adhesin A fusion protein in Escherichia coli: ability of CTB-PsaA to induce humoral immune response in mice", Biochem Biophys Res Commun, 321, pp.192~196 (2004)
- Briles DE, "Protection of the elderly from pneumococcal pneumonia with a protein-based vaccine?", Mech Ageing Dev, 125, pp.129~131 (2004)
- Green BA, "PppA, a surface-exposed protein of Streptococcus pneumoniae, elicits cross-reactive antibodies that reduce colonization in a murine intranasal immunization and challenge model", Infect Immun, 73, pp.981~989 (2005)
- Ogunniyi AD, "Immunization of mice with combinations of pneumococcal virulence proteins elicits enhanced protection against challenge with Streptococcus pneumoniae", Infect Immun, 68, pp.3028~3033 (2000)
- Glück U, "Ingested probiotics reduce nasal colonization with pathogenic bacteria (Staphylococcus aureus, Streptococcus pneumoniae, and beta-hemolytic streptococci)", Am J Clin Nutr, 77, pp.517~520 (2003)
- Roos K, "Effect of recolonisation with "interfering" alpha streptococci on recurrences of acute and secretory otitis media in children: randomised placebo controlled trial", BMJ, 322, pp.210~212 (2001)
- Park CW, "Detection rates of bacteria in chronic otitis media with effusion in children", J Korean Med Sci, 19, pp.735~738 (2004)
- 정도석, "소아에서 이루를 동반한 중이염의 원인 및 항균제 감수성", 소아감염, 7(2), pp.233~239 (2000), 한국소아감염병학회
- 박홍준, "만성 삼출성 중이염 저류액과 아데노이드 조직에서 중합효소연쇄반응(PCR)을 이용하여 검출된 세균의 비교", 대한이비인후과학회지, 43, pp.913~917 (2000)
- 김소희, "15년간(1991∼2005년) 우리나라 소아에서 분리된 폐구균의 혈청형 분포의 변화", 소아감염, 13(2), pp.89~98 (2006), 한국소아감염병학회
