Abstract
Acute otitis media is one of the most common diseases in children aged 0-24 months and Streptococcus pneumoniae is the most frequently isolated bacterial pathogen of acute otitis media. It is well established and documented that the heptavalent pneumococcal conjugate vaccine reduces the frequency of otitis media, especially caused by vaccine-serotype pneumococcus (4, 6B, 9, 14, 18C, 19F, 23F). However, this effect depends on the serotype distribution of isolated otopathogenic pneumococcal strains. Aim of this study was to determine the serotype distribution and antimicrobial resistance of pneumococcal strains causing acute otitis media in children aged 0-24 months. Between year 2002 and 2005 we investigated 73 pneumoccocal strains isolated from middle ear fluids of children aged 0-24 months in 10 pediatric centers in Budapest, Hungary. After bacteriological identification, pneumococcal serotyping was performed through Quellung reaction in the Microbiological Laboratory of Szent Lászlo Hospital Budapest, Hungary. Antimicrobial resistance was determined according to the international standards accepted by the Hungarian Society for Microbiology. The 73 strains represented 14 different serotypes. The most common were serotypes 14 (13.7 %), 19F (13.7 %), 6B (13.7 %), 23A (11 %) and 3 (9.6 %). Coverage ratio of the heptavalent pneumococcal conjugated vaccine was 63 %. Intermediate penicillin susceptibility was 41 % among all serotypes and 90 % among vaccine-serotypes. No high level penicillin resistant strains were found. Among intermediate penicillin susceptible strains serotype 9V, 14 and 19F were the most frequent. Serotype distribution of otopathogenic pneumococcal strains and coverage ratio of heptavalent conjugated pneumococcal vaccine in Hungary are similar to the result found in other geographic regions. In conclusion, we suppose that use of the pneumococcal conjugated vaccines in Hungary would provide same effectiveness against acute otitis media showed in previous multinational efficacy trials.
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