Pneumococcal phenotype and interaction with nontypeable Haemophilus influenzae as determinants of otitis media progression Academic Article uri icon


  • Background: All-cause otitis media (OM) incidence has declined in numerous settings following introduction of pneumococcal conjugate vaccines (PCVs) despite increases in carriage of non-vaccine pneumococcal serotypes escaping immune pressure. To understand the basis for declining incidence, we assessed the intrinsic capacity of pneumococcal serotypes to cause OM independently and in polymicrobial infections involving nontypeable Haemophilus influenzae (NTHi) using samples obtained from middle ear fluid and nasopharyngeal cultures before PCV7/13 rollout. Methods: Data included OM episodes (11,811) submitted for cultures during a 10-year prospective study in southern Israel and nasopharyngeal samples (1588) from unvaccinated asymptomatic children in the same population. We compared pneumococcal serotype diversity across carriage and …

publication date

  • January 1, 2018