015 - PNEUMOCOCCAL AND SEROTYPE CONTRIBUTION: POSSIBLE PREVENTION BY PCVS OF RECURRENT ACUTE OTITIS MEDIA (RAOM) IN CHILDREN (ID 106)
Abstract
Background
Background. Expanded valency PCVs, such as PCV20 are currently under clinical development. We evaluated the contribution of Streptococcus pneumoniae (Spn) and Spn serotypes to RAOM during the PCV13 use period and assessed antimicrobial susceptibility and possible prevention by PCVs.
Methods
Methods. Children <= 59 months of age with AOM were prospectively enrolled from 2010-2019 in outpatient clinics in Rochester, NY. A clinical diagnosis of AOM was made according to American Academy of Pediatrics criteria. RAOM was defined as ≥3 AOM episodes in 6 months or ≥4 AOM episodes in 12 months. Spn was isolated from middle ear fluid by tympanocentesis and serotyped by Quellung. Serotypes were classified as PCV13/non-PCV7 (6 serotypes in PCV13 beyond PCV7); PCV20/non-PCV7 (13 serotypes in PCV20 beyond PCV7); and PCV20/non-PCV13 (7 serotypes in PCV20 beyond PCV13). Antimicrobial testing was performed using Vitek-2 and non-susceptibility was determined according to CLSI standards.
Results
Results. Children with AOM were identified (median age [minimum, maximum]: 11.8 months [5.3, 45.9]) and 158 were Spn positive. Among these, 82 (52%) were RAOM yielding 84 non-duplicate Spn isolates. Among the 84 Spn isolates, 9 (11%) were PCV13/non-PCV7; 26 (31%) were PCV20/non-PCV13; and 35 (42%) were PCV20/non-PCV7. The percent of RAOM Spn PCV20/non-PCV7 isolates that were non-susceptible to penicillin (oral), erythromycin, and TMP/SMX, or were multi-drug resistant were 15%, 47%, and 19%, or 15%, respectively.
Conclusions
Conclusion. Spn significantly contributes to childhood RAOM. Expanded valency PCV20 has the potential to address a significant remaining burden of RAOM in children in the United States.
