Department of Laboratory, Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, China.
School of Public Health, Guangdong Pharmaceutical University, 283# Jianghai Dadao, Haizhu District, Guangzhou, 510310, China.
BMC Infect Dis. 2019 Feb 15;19(1):168. doi: 10.1186/s12879-019-3795-8.
The etiology and epidemiology of acute otitis media (AOM) are poorly understood in China. This study aimed to describe the etiology of AOM and the phenotypic and molecular characteristics of AOM-causing Streptococcus pneumoniae (S.pneumoniae) recovered from Chinese children.
A retrospective study was conducted to enrol patients younger than 18 years diagnosed as AOM. Middle ear fluid specimens were collected then cultured for bacterial pathogens. All S.pneumoniae isolates were tested for antibiotic susceptibility, serotypes, virulence genes, antibiotic resistant determinants and sequence types.
The dominant otopathogen among AOM children was S.pneumoniae (54.4%). Among S.pneumoniae isolates, there were 97.3, 97.3 and 75.7% isolates resistant to erythromycin, tetracycline and trimethoprim-sulfamethoxazole, respectively. There was 72.8% S.pneumoniae with multidrug resistance. The dominant sequence types (STs) were ST271 and ST320, whereas the prevailing serotypes were 19F and 19A. The 7-valent and 13-valent pneumococcal conjugate vaccine (PCV) coverage among AOM children were 73.0 and 94.6%, respectively. Additionally, we found that CC271 expressed more of mef(A/E) (P < 0.001), pspA (P = 0.022) and sipA (P < 0.001) than non-CC271 isolates.
The high prevalence of international multidrug-resistant clone (Taiwan-14) in China necessitates continued dedication to expand PCV13 immunization and better control of antibiotic use in China.
急性中耳炎（AOM）的病因和流行病学在中国尚未被充分了解。本研究旨在描述 AOM 的病因，以及从中国儿童中分离出的致 AOM 肺炎链球菌（S.pneumoniae）的表型和分子特征。
进行了一项回顾性研究，纳入年龄在 18 岁以下被诊断为 AOM 的患者。采集中耳液标本进行细菌病原体培养。对所有 S.pneumoniae 分离株进行抗生素敏感性、血清型、毒力基因、抗生素耐药决定因素和序列型检测。
AOM 患儿中主要的耳病原体是 S.pneumoniae（54.4%）。在 S.pneumoniae 分离株中，分别有 97.3%、97.3%和 75.7%的分离株对红霉素、四环素和甲氧苄啶-磺胺甲噁唑耐药。有 72.8%的 S.pneumoniae 呈多重耐药。主要的序列型（ST）是 ST271 和 ST320，而主要的血清型是 19F 和 19A。AOM 患儿中 7 价和 13 价肺炎球菌结合疫苗（PCV）的覆盖率分别为 73.0%和 94.6%。此外，我们发现 CC271 表达的 mef(A/E)（P<0.001）、pspA（P=0.022）和 sipA（P<0.001）多于非 CC271 分离株。
中国国际多重耐药克隆（台湾-14）的高流行率需要继续致力于扩大 PCV13 免疫接种，并更好地控制中国的抗生素使用。
