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Abstract
Bacterial Etiology and Pneumococcal Serotypes in Turkish Children with Acute Otitis Media
Mehmet Ceyhan, Yasemin Ozsurekci, Nezahat Gürler, Eda Karadag Oncel, Melda Celik, Ahmet Emre Aycan, Venhar Gurbuz, Umut Akyol, Ozan Altuntaş, Adnan Karabent, Yıldız Camcıoğlu, Mehmet Ada, Emre Alhan and Özlem Özgür
Background: Acute otitis media (AOM) is one of the most common childhood diseases requiring antimicrobial prescription drugs in pre-school children. In this study, we sought to describe the bacterial etiology of pediatric cases of AOM in Turkey. Materials and Methods: This prospective, multi-center, tympanocentesis-based epidemiological study was performed during 2010-2012in children aged between3 months and 6 years. All isolates were cultured and sero grouped by the Quellung reaction. Results: During 2010-2012, 38 cases fulfilled the study inclusion criteria. Overall, 45% of samples were culture positive for bacterial pathogens Streptococcus pneumonia (13.1%) was the leading cause of bacterial AOM followed by Streptococcus pyogenes (10.5%) and H. influenzae (7.9%). Serotype-3 was detected in two of the samples, and serotypes 9V, 19, and 19A were isolated from one patient each. S. pneumoniae was detected in 36% (4/11) of otorrhea samples. All H. influenzae-positive samples were collected by tympanocentesis. All H. influenzae isolates were identified as non-typeable. The pneumococcal serotype coverage rates for PCV-7, PVC-10 and PCV-13 were 20% (1/5), 20% (1/5), and 80% (4/5), respectively. PHiD-CV (PCV-7 types plus 1, 5, and 7F) targets non-typeable H. influenzae, and 4 of 38 (11%) of the pathogens causing episodes of AOM were also covered. Conclusion and Recommendation: In Turkey, S.pneumonia remains the most common pathogen in children with AOM. Both S. pneumonia and non-typeable H. influenzae represent important targets for vaccination strategies to reduce AOM in children. Based on our results, conjugated pneumococcal vaccines may have potential impact to decrease the burden of AOM.