ArticlePloS one2019
Bacterial causes of otitis media with spontaneous perforation of the tympanic membrane in the era of 13 valent pneumococcal conjugate vaccine.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04807660 (Bacteriological Evaluation of Spontaneous Otorrhea in Children), which is not on this map. Cited by 13 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Bacteriological Evaluation of Spontaneous Otorrhea in Children
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Defining the Terminology for Acute Ear Discharge in Children: Systematic Review and Expert Consensus Using the Nominal Group Technique.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2025Pooled it
- Serotype distribution of invasive and non-invasive pneumococcal disease in children ≤5 years of age following the introduction of 10- and 13-valent pneumococcal conjugate vaccines in infant national immunization programs: a systematic literature review.Frontiers in public health · 2025Pooled it
- Pooled it
- Management of acute otitis media with otorrhea in Italian pediatric practice: a national survey.Italian journal of pediatrics · 2026Article
- A Cost-Effectiveness Analysis of the Switch to 20-Valent Pneumococcal Conjugate Vaccine from Lower-Valent Pneumococcal Conjugate Vaccines in the French Pediatric Population.Infectious diseases and therapy · 2025Article
- Bacterial Acute Otitis Media Complicated with Otorrhea in a Children's Hospital in the Era of Pneumococcal Conjugate Vaccines.Pathogens (Basel, Switzerland) · 2025Article
- Characterization ofFrontiers in pediatrics · 2024Article
- Antibiotic Resistance ofAntibiotics (Basel, Switzerland) · 2023Article
- Estimating the Cost-Effectiveness of Switching to Higher-Valency Pediatric Pneumococcal Conjugate Vaccines in the United Kingdom.Vaccines · 2023Article
- Dynamic changes in otopathogens colonizing the nasopharynx and causing acute otitis media in children after 13-valent (PCV13) pneumococcal conjugate vaccination during 2015-2019.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Bacterial Spectrum of Spontaneously Ruptured Otitis Media in a 7-Year, Longitudinal, Multicenter, Epidemiological Cross-Sectional Study in Germany.Frontiers in medicine · 2021Article
- Nasopharyngeal carriage rates and serotype distribution ofAccess microbiology · 2021Article
- Panel 8: Vaccines and immunology.International journal of pediatric otorhinolaryngology · 2020Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
After pneumococcal conjugate vaccine (PCV) implementation, the number of acute otitis media (AOM) episodes has decreased, but AOM still remains among the most common diagnoses in childhood. From 2% to 17% of cases of AOM feature spontaneous perforation of the tympanic membrane (SPTM). The aim of this study was to describe the bacteriological causes of SPTM 5 to 8 years years after PCV13 implementation, in 2010. From 2015 to 2018, children with SPTM were prospectively enrolled by 41 pediatricians. Middle ear fluid was obtained by sampling spontaneous discharge. Among the 470 children with SPTM (median age 20.8 months), no otopathogen was isolated for 251 (53.4% [95% CI 48.8%;58.0%]): 47.1% of infants and toddlers, 68.3% older children (p<0.001). Among children with isolated bacterial otopathogens (n = 219), non-typable Haemophilus influenzae (NTHi) was the most frequent otopathogen isolated (n = 106, 48.4% [95% CI 41.6%;55.2%]), followed by Streptoccocus pyogenes (group A streptococcus [GAS]) (n = 76, 34.7% [95% CI 28.4%;41.4%]) and Streptococcus pneumoniae (Sp) (n = 61, 27.9% [95% Ci 22.0%;34.3%]). NTHi was frequently isolated in infants and toddlers (53.1%), whereas the main otopathogen in older children was GAS (52.3%). In cases of co-infection with at least two otopathogens (16.9%, n = 37/219), NTHi was frequently involved (78.4%, n = 29/37). When Sp was isolated, PCV13 serotypes accounted for 32.1% of cases, with serotype 3 the main serotype (16.1%). Among Sp strains, 29.5% were penicillin-intermediate and among NTHi strains, 16.0% were β-lactamase-producers. More than 5 years after PCV13 implementation, the leading bacterial species recovered from AOM with SPTM was NTHi for infants and toddlers and GAS for older children. In both age groups, Sp was the third most frequent pathogen and vaccine serotypes still played an important role. No resistant Sp strains were isolated, and the frequency of β-lactamase-producing NTHi did not exceed 16%.
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