Epidemiology of acute otitis media caused by Streptococcus pneumoniae before and after licensure of the 7-valent pneumococcal protein conjugate vaccine.

Abstract	We studied, by pulsed-field gel electrophoresis, multilocus sequence typing and penicillin-binding protein 2b amplicon-restriction profiles, pneumococcal isolates recovered from children with acute otitis media during 1 January-31 December 1999 and 2001. The proportion of nonvaccine serogroups increased from 14.8% (13/88) to 36.5% (23/63) from 1999 to 2001 (P<.01). Among children who received at least 2 doses of the pneumococcal 7-valent protein conjugate (PNC7) vaccine, 46.7% (7/15) of the isolates had nonvaccine serogroups, compared with 20.8% (26/125) of the isolates from children who did not receive the PNC7 vaccine (P=.05). Overall, the serogroups involved in capsular switching were 6-19-NT, 6-14-35, 15-19, and the 19-Spanish 23F clone. In 1999 and 2001, 30.8% (4/13) and 26.1% (6/23) of the nonvaccine serogroups were implicated in capsular switching, respectively. Continued surveillance will be of great importance as the distribution of the PNC7 vaccine increases.
Authors	M Catherine McEllistrem, Jennifer Adams, Edward O Mason, Ellen R Wald
Journal	The Journal of infectious diseases (J Infect Dis) Vol. 188 Issue 11 Pg. 1679-84 (Dec 01 2003) ISSN: 0022-1899 [Print] United States
PMID	14639539 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References	Bacterial Proteins Carrier Proteins Heptavalent Pneumococcal Conjugate Vaccine Meningococcal Vaccines Penicillin-Binding Proteins Pneumococcal Vaccines Peptidyl Transferases Hexosyltransferases Muramoylpentapeptide Carboxypeptidase
Topics	Acute Disease Bacterial Proteins (genetics) Carrier Proteins (genetics) Child Electrophoresis, Gel, Pulsed-Field Female Heptavalent Pneumococcal Conjugate Vaccine Hexosyltransferases (genetics) Humans Male Meningococcal Vaccines (immunology) Muramoylpentapeptide Carboxypeptidase (genetics) Otitis Media (microbiology, prevention & control) Penicillin-Binding Proteins Peptidyl Transferases (genetics) Pneumococcal Infections (microbiology, prevention & control) Pneumococcal Vaccines (immunology) Serotyping Streptococcus pneumoniae (classification)

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