Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA; Department of Otolaryngology, Harvard Medical School, Boston, MA.
Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA; Department of Otolaryngology, Harvard Medical School, Boston, MA.
J Pediatr. 2018 Oct;201:122-127.e1. doi: 10.1016/j.jpeds.2018.05.047. Epub 2018 Jun 27.
To examine the long-term trend of otitis media (OM)-associated ambulatory visits from 1997 to 2014 and to evaluate the impact of 7-valent and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13) on OM ambulatory visits.
We examined OM-associated ambulatory visits in children, using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey.
A total of 24 148 OM-related visits were identified from 363 240 ambulatory visits. OM visits accounted for 9.5% of all ambulatory visits in 1997-1999, 7.1% in 2002-2009, and 5.5% in 2012-2014. Between the pre-PCV7 and the post-PCV13 period, annual physician's office visits for OM declined from 826 to 387 visits per 1000 children among children younger than 2 years of age. Compared with the pre-PCV7 period, office visit rates for OM significantly declined by 51% (95% CI 42%-58%) among children younger than 2 years of age and by 37% (95% CI 23%-48%) among children 2-4 years of age during the post-PCV13 period. Among children younger than 2 years of age, emergency department visits for OM declined by 47% (95% CI 36%-55%) during the post-PCV13 period, and hospital outpatient visits declined by 30% (95% CI 8%-48%) during the PCV13-transition period. OM-related visits declined across sex, race/ethnicity, health insurance status, and geographic region.
Our nationwide study shows that ambulatory visits for OM have declined following the introduction of PCV7 and PCV13. Future research on the evolving microbiology of OM and continued monitoring of the epidemiology of pneumococcal disease are needed.
研究 1997 年至 2014 年中耳炎（OM）门诊就诊的长期趋势，并评估 7 价和 13 价肺炎球菌结合疫苗（PCV7 和 PCV13）对 OM 门诊就诊的影响。
我们使用国家门诊医疗调查和国家医院门诊医疗调查，研究儿童 OM 相关门诊就诊情况。
在 363240 次门诊就诊中，共发现 24148 次 OM 相关就诊。1997-1999 年，OM 就诊占所有门诊就诊的 9.5%，2002-2009 年占 7.1%，2012-2014 年占 5.5%。在 PCV7 前后期间，2 岁以下儿童因 OM 而每年到医生办公室就诊的次数从 826 次减少到 387 次。与 PCV7 前时期相比，2 岁以下儿童的 OM 就诊率在 PCV13 后时期显著下降了 51%（95%CI 42%-58%），2-4 岁儿童的 OM 就诊率下降了 37%（95%CI 23%-48%）。在 2 岁以下儿童中，PCV13 后时期因 OM 而到急诊就诊的次数下降了 47%（95%CI 36%-55%），PCV13 过渡时期到门诊就诊的次数下降了 30%（95%CI 8%-48%）。OM 相关就诊率在性别、种族/民族、医疗保险状况和地理位置上均有所下降。
我们的全国性研究表明，在引入 PCV7 和 PCV13 后，OM 的门诊就诊量有所下降。需要进一步研究 OM 不断变化的微生物学以及对肺炎球菌疾病的流行病学进行持续监测。
