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Pediatrics. 2017 Sep;140(3). pii: e20170181. doi: 10.1542/peds.2017-0181. Epub 2017 Aug 7.

Epidemiology of Acute Otitis Media in the Postpneumococcal Conjugate Vaccine Era.

Author information

1
Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York.
2
Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York michael.pichichero@rochesterregional.org.

Abstract

OBJECTIVES:

To study the epidemiology of acute otitis media (AOM), especially the otitis-prone condition, during the pneumococcal conjugate vaccines 7 and 13 era.

METHODS:

Six hundred and fifteen children were prospectively managed from 6 to 36 months of life during a 10-year time frame (June 2006-June 2016). All clinical diagnoses of AOM were confirmed by tympanocentesis and bacterial culture of middle ear fluid.

RESULTS:

By 1 year of age, 23% of the children experienced ≥1 episode of AOM; by 3 years of age, 60% had ≥1 episodes of AOM, and 24% had ≥3 episodes. The peak incidence occurred at 6 to 12 months of life. Multivariable analysis of demographic and environmental data revealed a significantly increased risk of AOM associated with male sex, non-Hispanic white race, family history of recurrent AOM, day care attendance, and early occurrence of AOM. Risk factors for stringently defined (tympanocentesis-confirmed) otitis proneness, in which children suffered at least 3 episodes of AOM in a 6-month period or at least 4 within a year, were male sex, day care attendance, and family history of AOM, whereas breastfeeding in the first 6 months of life was protective. Stringently defined otitis prone children were also likely to experience their first AOM episode at a younger age. The proportion of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis causing AOM had dynamic changes during the past decade.

CONCLUSIONS:

We conclude that the epidemiology but not the risk factors for AOM have undergone substantial changes since the introduction of pneumococcal conjugate vaccines.

PMID:
28784702
PMCID:
PMC5574724
DOI:
10.1542/peds.2017-0181
[Indexed for MEDLINE]
Free PMC Article

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