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Nasopharyngeal Carriage of Respiratory Pathogens in Children Undergoing Pressure Equalization Tube Placement in the Era of Pneumococcal Protein Conjugate Vaccine Use
Author(s) -
Jacobs Michael R.,
Good Caryn E.,
Sellner Tom,
Bajaksouzian Saralee,
Windau Anne,
A Jack B.
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000250490.49183.84
Subject(s) - medicine , streptococcus pneumoniae , serotype , moraxella catarrhalis , microbiology and biotechnology , carriage , pneumococcal conjugate vaccine , haemophilus influenzae , conjugate vaccine , penicillin , virology , cefuroxime , antibiotics , biology , pathology
Objective: To define carriage of bacterial respiratory pathogens in children undergoing pressure equalization tube placement. Study Design: Nasopharyngeal cultures were performed during tube placement. Antibiotic susceptibilities and serotypes of pneumococci were determined. Results: Sixty‐nine Streptococcus pneumoniae , 72 Haemophilus influenzae (41% β‐lactamase positive), and 39 Moraxella catarrhalis (all β‐lactamase positive) were isolated from 201 children. Overall, 42% of pneumococci were nonsusceptible to penicillin, and 34.8% were resistant to macrolides. In relation to the pneumococcal conjugate vaccine, 17.4% were vaccine, 31.9% vaccine‐related, and 50.7% nonvaccine serotypes. Conclusion: Twenty‐five percent of children colonized with pneumococci carried antibiotic resistant nonvaccine serotypes rarely detected before the introduction of pneumococcal conjugate vaccine, including serotype 19A isolates (7%) resistant to all oral agents tested and type 35B isolates (12%) nonsusceptible to penicillin and cefuroxime. Significance: Pneumococcal colonization suggests replacement of vaccine serotypes with vaccine related and nonvaccine serotypes, many of which are resistant to common oral antimicrobials.