Tawfik Kareem O, Ishman Stacey L, Altaye Mekibib, Meinzen-Derr Jareen, Choo Daniel I
1 Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
2 Divisions of Otolaryngology-Head & Neck Surgery and Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Otolaryngol Head Neck Surg. 2017 May;156(5):938-945. doi: 10.1177/0194599817699599. Epub 2017 Mar 28.
Objectives (1) Describe longitudinal trends in annual prevalence of hospital admission for pediatric acute otitis media (AOM) and complications of AOM (CAOM) since introduction of pneumococcal vaccination in 2000 and (2) describe the longitudinal trend of prevalence of hospital admission for pneumococcal meningitis in children with AOM-related diagnoses in the postvaccination era. Study Design Retrospective analysis of Kids' Inpatient Database from 2000 to 2012. Setting Community, nonrehabilitation hospitals. Subjects and Methods To determine annual prevalence of admission for AOM/CAOM, nationally weighted frequencies of children aged <21 years with acute suppurative otitis media, acute mastoiditis, suppurative labyrinthitis, and/or acute petrositis were collected. The frequency of coexisting pneumococcal meningitis diagnoses among these patients was also collected. Trend analysis of prevalences of admission for AOM/CAOM and for pneumococcal meningitis occurring in the setting of AOM/CAOM from 2000 to 2012 was performed. Results Between 2000 and 2012, annual prevalence of admission for AOM/CAOM decreased from 3.956 to 2.618 per 100,000 persons ( P < .0001) (relative risk reduction 34%). Declines in admission prevalence were most pronounced in children <1 year of age (from 22.647 to 8.715 per 100,000 persons between 2000 and 2012, P < .0001) and 1 to 2 years of age (from 13.652 to 5.554 per 100,000 persons between 2000 and 2012, P < .0001). For all ages, the admission prevalence for pneumococcal meningitis and concomitant AOM/CAOM decreased (from 1.760 to 0.717 per 1,000,000 persons, P < .0001) over the study period. Conclusions The prevalence of hospital admission for pediatric AOM/CAOM has declined since the advent of pneumococcal vaccination. Admission rates for pneumococcal meningitis with AOM/CAOM have similarly declined.
（1）描述自2000年引入肺炎球菌疫苗以来，儿童急性中耳炎（AOM）及AOM并发症（CAOM）的年度住院患病率的纵向趋势；（2）描述疫苗接种时代AOM相关诊断儿童中肺炎球菌脑膜炎住院患病率的纵向趋势。研究设计：对2000年至2012年儿童住院数据库进行回顾性分析。研究地点：社区非康复医院。研究对象与方法：为确定AOM/CAOM的年度住院患病率，收集了年龄＜21岁患有急性化脓性中耳炎、急性乳突炎、化脓性迷路炎和/或急性岩部炎儿童的全国加权频率。还收集了这些患者中并存肺炎球菌脑膜炎诊断的频率。对2000年至2012年AOM/CAOM住院患病率以及AOM/CAOM背景下肺炎球菌脑膜炎住院患病率进行趋势分析。结果：2000年至2012年期间，AOM/CAOM的年度住院患病率从每10万人3.956例降至2.618例（P＜0.0001）（相对风险降低34%）。住院患病率下降在1岁以下儿童中最为明显（从2000年至2012年每10万人22.647例降至8.715例，P＜0.0001）以及1至2岁儿童中（从2000年至2012年每10万人13.652例降至5.554例，P＜0.0001）。在整个研究期间，所有年龄段中，肺炎球菌脑膜炎及伴随AOM/CAOM的住院患病率均下降（从每100万人1.760例降至0.717例，P＜0.0001）。结论：自肺炎球菌疫苗问世以来，儿童AOM/CAOM的住院患病率有所下降。AOM/CAOM相关的肺炎球菌脑膜炎住院率也同样下降。
