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Archives de pédiatrie
Volume 15, n° 11
pages 1713-1716 (novembre 2008)
Doi : 10.1016/j.arcped.2008.09.003
Épidémiologie des otites moyennes aiguës à pneumocoque : émergence du sérotype 19A
Epidemiology of acute otitis media caused by Streptococcus pneumoniae : Emergence of serotype 19A

F. Mahjoub-Messai a, C. Doit a, P. Mariani-Kurkdjian a, M. François b, E. Bingen a,
a Service de microbiologie, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France 
b Service d’ORL, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France 

Auteur correspondant.

Cette étude rétrospective a pour objectif d’analyser l’épidémiologie des sérogroupes/sérotypes et le profil de sensibilité aux antibiotiques des souches de pneumocoque isolées lors d’otites moyennes aiguës récidivantes ou d’échecs de traitement entre le 1er janvier 2002 et le 30 juin 2008, soit après l’introduction du vaccin pneumococcique heptavalent conjugué en France. Cent vingt-six souches ont été isolées durant trois périodes par paracentèse ou otorrhée spontanée. Entre les périodes 1 (2002–2003) et 3 (2006–2008), nos données montrent une diminution de 39 à 13 % du sérotype 19F (p =0,03). À l’inverse, il existe une augmentation de la proportion du sérotype 19A, qui passe de 25 à 60 % (p =0,03). Les CMI90 de la pénicilline, de l’amoxicilline et du céfotaxime des souches de sérotype 19A sont, respectivement, de 1, 0,75 et 0,75mg/L.

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In this study, the authors report the distribution of serogroups/serotypes and their susceptibility profiles of Streptococcus pneumoniae causing recurrent and difficulties to treat acute otitis media (AOM) in children obtained at the ENT outpatient clinic of Robert Debré Hospital in Paris, between 2002–2008 after the implementation of the 7-valent pneumococcal conjugate vaccine. In this retrospective study, 126 S. pneumoniae isolates were obtained by tympanocentesis from 126 children with AOM during three different periods: 2002–2003 (period 1), 2004–2005 (period 2), and 2006–2008 (period 3). In period 1, the most common serotype was 19F. Between period 1 and period 3, the proportion of serotype 19F decreased from 39 to 13% (P =0.03). In contrast, the proportion of serotype 19A increased from 25 to 60% (P =0.03). So, they observed that vaccine-related serotype 19A became dominant among young children with AOM in 2006–2008. Overall, 15.1% of the isolates were penicillin susceptible, 73.8% intermediate and 11.1% were resistant. Most (94%) of the S. pneumoniae serotype 19A were penicillin intermediate.

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Mots clés : Streptococcus pneumoniae , Otite moyenne aiguë, Sérotype 19A, Vaccin heptavalent conjugué

© 2008  Elsevier Masson SAS. All Rights Reserved.
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