Table_1_Streptococcus pneumoniae Serotypes Carried by Young Children and Their Association With Acute Otitis Media During the Period 2016–2019.docx

Background:Streptococcus pneumoniae (Sp) is a major cause of acute otitis media (AOM). Pneumococcal conjugate vaccine (PCV) programs have altered pneumococcal serotype epidemiology in disease and carriage. In this study, we used samples collected during a cross-sectional study to examine if the clinical picture of acute otitis media (AOM) in young children exposed to the PCV program in Belgium was related to the carried pneumococcal strains, and if their carriage profile differed from healthy children attending daycare centers.Material/Methods: In three collection periods from February 2016 to May 2018, nasopharyngeal swabs and background characteristics were collected from children aged 6–30 months either presenting at their physician with AOM (AOM-group) or healthy and attending day care (DCC-group). Clinical signs of AOM episodes and treatment schedule were registered by the physicians. Sp was detected, quantified, and characterized using both conventional culture analysis and real-time PCR analysis.Results: Among 3,264 collected samples, overall pneumococcal carriage and density were found at similar rates in both AOM and DCC. As expected non-vaccine serotypes were most frequent: 23B (AOM: 12.3%; DCC: 17.4%), 11A (AOM: 7.5%; DCC: 7.4%) and 15B (AOM: 7.5%; DCC: 7.1%). Serotypes 3, 6C, 7B, 9N, 12F, 17F, and 29 were more often found in AOM than in DCC (p-value < 0.05), whereas 23A and 23B were less often present in AOM (p-value < 0.05). Antibiotic non-susceptibility of Sp strains was similar in both groups. No predictors of AOM severity were identified.Conclusion: In the present study, overall carriage prevalence and density of S. pneumoniae were found similar in young children with AOM and in healthy children attending day-care centers in Belgium. Certain serotypes not currently included in the PCV vaccines were found to be carried more often in children with AOM than in DCC, a finding that might suggest a relationship between these serotypes and AOM.

背景：肺炎链球菌（Sp）是急性中耳炎（AOM）的主要病因。肺炎球菌结合疫苗（PCV）计划已改变了疾病和携带的肺炎球菌血清型流行病学。在本研究中，我们利用在比利时进行的一项横断面研究期间收集的样本，以探讨接受PCV计划的小儿急性中耳炎（AOM）的临床表现是否与携带的肺炎球菌菌株相关，以及他们的携带特征是否与参加托儿所的健康儿童有所不同。材料/方法：在2016年2月至2018年5月的三个收集时期，从6至30个月大的儿童中收集了鼻咽拭子和背景特征，这些儿童要么因AOM在医生处就诊（AOM组），要么健康并参加日托（DCC组）。医生记录了AOM发作的临床症状和治疗计划。使用传统培养分析和实时PCR分析来检测、定量和表征Sp。结果：在3,264个收集的样本中，AOM组和DCC组的总体肺炎球菌携带率和密度发现相似。如预期，非疫苗血清型最为常见：23B（AOM：12.3%；DCC：17.4%），11A（AOM：7.5%；DCC：7.4%）和15B（AOM：7.5%；DCC：7.1%）。血清型3、6C、7B、9N、12F、17F和29在AOM中比在DCC中更常见（p值<0.05），而23A和23B在AOM中出现的频率较低（p值<0.05）。两组中Sp菌株的抗生素非耐药性相似。未识别出AOM严重程度的预测因子。结论：在本研究中，发现比利时AOM儿童和参加日托的健康儿童的肺炎链球菌总体携带率和密度相似。某些目前未包含在PCV疫苗中的血清型在AOM儿童中的携带频率高于DCC儿童，这一发现可能表明这些血清型与AOM之间存在关联。