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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Pediatr+Infect+Dis+J
2017 ; 36
(3
): 274-281
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gab.com Text
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English Wikipedia
Etiology of Acute Otitis Media in Children Less Than 5 Years of Age: A Pooled
Analysis of 10 Similarly Designed Observational Studies
#MMPMID27918383
Van Dyke MK
; Pirçon JY
; Cohen R
; Madhi SA
; Rosenblüt A
; Macias Parra M
; Al-Mazrou K
; Grevers G
; Lopez P
; Naranjo L
; Pumarola F
; Sonsuwan N
; Hausdorff WP
Pediatr Infect Dis J
2017[Mar]; 36
(3
): 274-281
PMID27918383
show ga
BACKGROUND: Acute otitis media (AOM) is an important cause of childhood morbidity
and antibiotic prescriptions. However, the relative importance of the well-known
otopathogens, Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hflu),
remains unclear because of a limited number of tympanocentesis-based studies that
vary significantly in populations sampled, case definitions and heptavalent
pneumococcal conjugate vaccine use. METHODS: We conducted a pooled analysis of
results from 10 AOM etiology studies of similar design, the protocols of which
were derived from a common protocol and conducted in children 3 months to 5 years
of age in different countries. Generalized estimating equations were used to
account for within-study correlations. RESULTS: The majority, 55.5% (95%
confidence interval: 47.0%-65.7%) of 1124 AOM episodes, were bacterial pathogen
positive: 29.1% (24.8%-34.1%) yielded Hflu and 23.6% (19.0%-29.2%) Spn.
Proportions of Hflu and Spn were higher and lower, respectively, in heptavalent
pneumococcal conjugate vaccine-vaccinated children. Hflu and Spn were each
isolated from 20% to 35% of children in every 1-year age range. Hflu was less
likely to be isolated from first (vs. subsequent) episodes [relative risk (RR):
0.71 (0.60-0.84)]. Spn was more often isolated from sporadic (vs. recurrent)
cases [RR: 0.76 (0.61-0.97)]; the opposite was true for Hflu [RR: 1.4
(1.00-1.96)]. Spn cases were more likely to present with severe (vs. mild)
symptoms [RR: 1.42 (1.01-2.01)] and Hflu cases with severe tympanic membrane
inflammation [RR: 1.35 (1.06-1.71)]. CONCLUSIONS: Spn and Hflu remain the leading
otopathogens in all populations examined. While associated with overlapping
symptoms and severity, they exhibit some differences in their likelihood to cause
disease in specific subpopulations.