Acute Otitis Media Epidemiology Changed With Pneumococcal Vaccines

HealthDay News — Since the introduction of pneumococcal vaccines, the epidemiology of acute otitis media (AOM) has changed considerably, but risk factors have not, according to a study published in Pediatrics.

Ravinder Kaur, PhD, from the Rochester General Hospital Research Institute in New York, and colleagues examined the epidemiology of AOM in a cohort of 615 children, prospectively managed from 6 to 36 months of life during a 10-year time frame (June 2006 to June 2016). AOM diagnoses were confirmed by tympanocentesis and bacterial culture of middle ear fluid.

The researchers found that male sex, non-Hispanic white race, family history of recurrent AOM, day care attendance, and early occurrence of AOM were associated with significantly increased risk of AOM. 

Risk factors for stringently defined proneness to otitis, in which children had 3 or more episodes of AOM in a 6-month period or 4 episodes within 1 year, included male sex, day care attendance, and family history of AOM; breastfeeding in the first 6 months was a protective factor. Children who were prone to stringently defined otitis were also likely to experience their first episode of AOM at an earlier age. During the past decade there was a dynamic change in the proportion of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis causing AOM.

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

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Kaur R, Morris M, Pichichero ME. Epidemiology of acute otitis media in the postpneumococcal conjugate vaccine era [published online August 7, 2017]. Pediatrics. doi: 10.1542/peds.2017-0181.