Otorrhea bacterial profile, epidemiology before widespread use of the third-generation pneumococcal conjugate vaccine in French children, a prospective study from 2015 to 2023

Objectives: The aim of this study was to describe the bacterial profile of middle ear fluid from spontaneous perforation of the tympanic membrane (SPTM) prior to widespread utilization of third- generation pneumococcal conjugate vaccines (PCVs). Patients and methods: From October 2015 to January 2023, children with SPTM were prospectively enrolled by pediatricians. Results: Among the 852 children with SPTM, 73.2% were less than 3 years old; more frequently than older children, they were and suffering from complex acute otitis media (AOM) (27.9%) and conjunctivitis (13.1%). In children under 3 years of age, NT Haemophilus influenzae (49.7%) was the main otopathogen isolated, particularly in those with complex AOM (57.1%). In children over 3 years of age, Group A Streptococcus accounted for 57%. In pneumococcal cases (25.1%), serotype 3 was the main serotype isolated (16.2%), followed by 23B (15.2%). Conclusion: Our data from 2015 to 2023 represent a robust baseline preceding the widespread utilization of next-generation PCVs.

Automated summary

The aim of this study was to describe the bacterial profile of middle ear fluid from spontaneous perforation of the tympanic membrane (SPTM) prior to widespread utilization of third- generation pneumococcal conjugate vaccines (PCVs). The results showed that in children under 3 years of age, NT Haemophilus influenzae was the main otopathogen isolated, particularly in those with complex acute otitis media. In children over 3 years of age, Group A Streptococcus accounted for the majority of cases.