The Effect of Immunization with Pneumococcal Vaccines (Prevenar) on Acute Otitis Media in Neonates

Objective: to assess the epidemiological and microbiological characteristics of acute otitis media in neonates (0-2 months) before and after the introduction of pneumococcal vaccine (prevenar 13) into the routine national immunization program.

Methods: all neonates with acute otitis media(AOM) aged ≤ 2 months that had presented to the pediatric emergency room between the years 2005-2009(pre-vaccine period – group A) and 2010-2014 (post-vaccine period – group B) were enrolled in the study. We retrospectively collected demographics, microbiology and other characteristics of the disease.

Results: 125 neonates were found in group A, of which 92 had gone through tympanocintesis. In group B 178 neonates were found, of which 91 tympanocintesis were abducted. No major differences were found between the two groups regarding the presentation (fever, leucocyte count extra).

The major difference was found to be the bacterial growth from the ear cultures. Strep. Pneumonia was the most common bacteria found in group A (49%) followed by H.influenza (24%),GAS(5%), M. cataralis (1%). 21% of the ear cultures were sterile. In group B sterile culture was the most common finding (37%), followed by Strep. Pneumonia (29%) H.influenza (21%), M. cataralis (8%), GAS (4%).

Conclusion: as can be observed by our findings a shift was found in pathogen causing AOM in neonates. From a mainly pneumococcal disease, most cultures are now sterile, which represent most probably a viral infection.