R Dagan

..To determine the relation between early bacteriologic eradication and clinical outcome of acute otitis media (AOM) in infants and young children treated with various antibiotics...

..This review is meant to assist the clinician in both a better understanding of the current recommendations for the treatment of AOM and the steps to be taken to follow AOM patients...

..Antibody concentrations or measurements of antibody functionality may provide a means to anticipate a predicted outcome in pneumococcal pneumonia for certain emergent vaccine candidates...

..The objective of this study was to determine the association between early bacteriologic failure and clinical failure in acute otitis media (AOM)...

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..We compared the effect of these two schedules on pneumococcal carriage in young children. We also assessed the effect of a 2-dose schedule in the second year ("catch-up" schedule; 0+2)...

..To describe the clinical, epidemiological and antimicrobial resistance patterns of Costa Rican children with otitis media caused by Streptococcus pneumoniae serotype 3...

..The objective of this study was to investigate whether pneumococcal carriage around the time of the first dose of 7-valent PCV (PCV7) affects serotype-specific immunologic response...

..These observations underline the need to carefully evaluate upcoming pediatric conjugate vaccines for possible interference effects on the coadministered antigens, with particular attention to hepatitis B and Hib-tetanus toxoid...

..We attempted to determine whether reduced antibiotic consumption, which is observed yearly in children during the warm season, is associated with a reduction in antibiotic resistance in pneumococcal acute otitis media (AOM)...

..Further strategies include expansion of PCV serotype coverage, development of protein-based vaccines, and further limitation of antibiotic use...

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..A causative role of PCV7 was speculated. We prospectively studied the dynamics of acute otitis media (AOM) caused by Sp19A in southern Israel before the introduction of PCV7...

..Novel carriers avoiding these issues could enable the further development of pediatric schedules and combinations...

..Predominant post-PCV7 NVTs include serotypes 15, 19A, and 33F, but the increasing antibiotic resistance of 19A is of particular concern in both vaccinated and unvaccinated populations...

..The incidence of vaccine-serotype IPD varies widely in geographically disparate regions, indicating that serotype coverage alone may not accurately predict the impact of proposed pneumococcal conjugate vaccines with additional serotypes...

..Further analysis of the data has indicated that failure to eradicate bacteria from the middle ear fluid is strongly correlated with clinical failure...

..4 per 100 000 during 1993-1998. A 2-dose universal hepatitis A immunization program aimed at children aged 18 and 24 months (without a catch-up campaign) was started in 1999...

..We attempted to correlate postvaccination serum serotype-specific pneumococcal anticapsular immunoglobulin (Ig) G concentrations with new acquisitions of vaccine-type (VT) serotypes and the VT-related serotype 6A...

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..Although antibiotics differ in their resistant-promotion potential, all still do promote resistance...

..To determine the bacteriologic efficacy of ceftriaxone in nonresponsive acute otitis media in children...

..14%, P = .042). Conjugate pneumococcal vaccines may reduce spread of pneumococci in the community...

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..Whether these efforts will prove successful or, even if successful, will only modify the clinical and bacteriologic picture presenting new challenges, only time will tell...

..To date no studies have evaluated early dynamics of pneumococcal NP carriage during antibiotic treatment...

..To characterize NTHi AOM a large database of culture-positive AOM cases was analyzed...

..This is an important mechanism by which, in recently treated patients, AOM infections often become refractory to treatment...

..Polysaccharide vaccine may be helpful in terminating pneumococcal outbreaks but may not affect pneumococcal carriage...

..Pneumococcal nasopharyngeal colonization is important for transmission of the organisms. We assessed the ability of two tetravalent conjugate vaccines administered in early infancy to prevent carriage of vaccine-related pneumococci...

..The results suggest that, if efficacious, the conjugate pneumococcal vaccines can substantially reduce the occurrence of pneumococcal AOM in general and complicated pneumococcal AOM in particular...

..The study compared nasopharyngeal carriage of resistant pneumoniae in human immunodeficiency virus (HIV)-seropositive and -seronegative children...

..influenzae. It is proposed that susceptibility breakpoints for H. influenzae should be considerably lower than the current ones for both cefaclor and azithromycin for AOM caused by H. influenzae...

..Because of the increasing resistance of Streptococcus pneumoniae and Haemophilus influenzae to T/S, we undertook the present study to investigate the bacteriologic and clinical efficacy of this drug in AOM...

..The 9- and 11-valent pneumococcal conjugate vaccines have the potential to substantially decrease invasive pneumococcal disease in southern Israel...

..We assessed in young infants the safety and immunogenicity of two tetravalent vaccines containing pneumococcal 6B, 14, 19F and 23F polysaccharides conjugated to either tetanus toxoid (Pnc-T) or diphtheria toxoid (Pnc-D)...

..No significant differences in bacterial size or the capsular amount could be found between 14R and 14DW. We conclude that factor(s) in addition to the capsule, contribute to disease outcome...

..We have identified 6PGD as a surface-located immunogenic lectin protein capable of acting as an adhesin. 6PGD importance to bacterial pathogenesis was demonstrated by the ability of r6PGD to elicit a protective immune response in mice...

..These data suggest that persistent diarrhea is a clinical entity that may be related less to a specific enteric pathogen and more to the health experiences of children and their home environment...

..The inconvenience of this parenteral regimen created an increased need for oral pediatric formulations for the treatment of invasive diarrhea...

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..pneumoniae, including multiply resistant S. pneumoniae, in DCC attendees is high. Pneumococcal conjugate vaccines seem to be an important tool for reducing the carriage rate of antibiotic-resistant pneumonia in DCCs...

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..kingae infection. The prevalence of pharyngeal carriage among surgical patients was 8.0%, and the organism was not isolated from any of the infants younger than 6 months attending the well-baby-care clinic...

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..Incidence and severity of respiratory infections are increased in day-care center attendees. Streptococcus pneumoniae is an important contributor to these infections...

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..In contrast, serotype 6B and 23F strains showed different phenotypic characteristics as well as multiple clonal types; 10 clones were identified among 6B isolates, and 11 clones were identified among 23F isolates...

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..Vaccinating DCC attendees with a 7-valent pneumococcal conjugate vaccine may play a key role in controlling the spread of antibiotic-resistant pneumococci, because the most resistant serotypes are included in the vaccine...

..CONCLUSION: PncDT11 is safe and immunogenic in infants. The use of 11-valent pneumococcal vaccine would increase the serotype coverage beyond the currently available 7-valent vaccine...

..CONCLUSION: The marked effect of PnCRM9 administration to DCC attendees on carriage of VT and antibiotic-resistant S. pneumoniae among their younger household close contacts demonstrates a herd effect of the vaccine...

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..Preliminary studies show that conjugate pneumococcal vaccine might reduce the nasopharyngeal pneumococcal carriage in general, and of resistant organisms in particular...

..This phenomenon, which we believe derives from interference by a common protein carrier, should be taken into account when the introduction of an immunization program including multiple conjugate vaccines is considered...

..These observations suggest a possible epidemiologic connection between the flora of S. pneumoniae colonizing healthy children in closed communities and the flora found in children hospitalized for infection...

..Giardiasis is a common protozoan infection with clinical manifestations in children ranging from asymptomatic carriage to persistent diarrhoea with malabsorption. It can lead to growth and developmental retardation...

..We conclude that intravenous wide-spectrum antibiotic therapy in conjunction with daily suction and débridement is efficacious for the treatment of chronic suppurative otitis media without cholesteatoma...

..Judicious use of antibiotics for the treatment of AOM will have a major impact on society, leading to a less frequent but more skilled administration of the most effective drugs...

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..A marked increase in the rate of nosocomial Klebsiella bacteremia occurred at all departments. Resistance to third-generation cephalosporins emerged frequently at PICU and NICU during the last period of the survey...

..The reduction of overall S. pneumoniae nasopharyngeal carriage by both ceftriaxone regimens was a short-lived phenomenon followed by rapid recolonization of the nasopharynx...

..We investigated the relationship between MEF culture-positivity during treatment in patients with clinical improvement/cure, and the occurrence of subsequent AOM...

..4 mg/kg/day) against common bacterial pathogens causing acute otitis media (AOM), including penicillin-resistant Streptococcus pneumoniae (PRSP)...

..The rates of systemic reactions were 23.8% after the first dose and 11.4% after the booster dose. Overall, this trial demonstrated the good safety and immunogenicity profile of this vaccine in children aged 18 months to 15 years of age...

..The ability of primed infants to mount a rapid response is an important observation given the high risk of Hib infection at this critical age...

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..However, data regarding the bacteriologic and clinical efficacy of this regimen in the treatment of nonresponsive acute otitis media are incomplete...

..To determine clinical characteristics of AOM at presentation and during therapy according to specific etiologies...

..The BACTEC blood culture system enhances the recovery of K. kingae from joint fluid and improves bacteriologic diagnosis of pediatric septic arthritis...

..pneumoniae...

..Our findings should alert physicians on the choice of appropriate antibiotic treatment, on the frequent copresence of acute otitis media and on the potential role of conjunctivitis in the spread of antibiotic-resistant pathogens...

..Because its overall clinical efficacy is good, high dose amoxicillin is still an appropriate choice as first line empiric therapy for AOM, followed by a beta-lactamase-stable drug in the event of failure...

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..Epidemiologically unrelated organisms showed greater variability, and no strain represented >5% of isolates. The present results support person-to-person transmission of K. kingae among young children in the day care setting...

..The organism is susceptible to a wide range of antimicrobial drugs, and with the exception of some cases of endocarditis, K. kingae infections in children usually run a benign clinical course...

..Faltering growth was shown to be subsequent to G. lamblia infection rather than preceding it. Our findings confirm that G. lamblia carriage is not associated with diarrhea. However, the effect on growth deserves further investigation...

..samples negative for bacterial pathogens. CONCLUSIONS: WBC counts were higher in the MEF of patients with culture-positive AOM than in those with culture-negative AOM and in those with AOM caused by S. pneumoniae...

..Isolation of S. pneumoniae and fever were each significantly associated with increased peripheral leukocyte and ANCs...

..We hypothesized that toddler's vaccination in a population living in an endemic area would reduce virus circulation, resulting in reduced HAV seropositivity rates in unvaccinated toddlers...

..pneumoniae. The development of new antimicrobial agents and formulations should be aimed at meeting PK/PD parameters predictive of bacterial eradication of both susceptible and resistant strains...

..pyogenes and lower rates of nontypable H. influenzae recovery; (5) penicillin-nonsusceptible S. pneumoniae played only a minor role in the etiology of acute mastoiditis in Southern Israel...

..Proteins identified by sera from mice immunized with the cell-wall derived fractions may constitute candidates for future development of anti S. pneumoniae vaccines...

..We compared the originally licensed regimen to 2 widely used alternative regimens...

..influenzae from the middle ear space. In the United States, widespread pneumococcal vaccination has increased the importance of H. influenzae as a major therapeutic challenge in the treatment of AOM...

..pneumonia was the most common pathogen isolated in middle ear fluid cultures, the involvement of S. pyogenes in AM was higher than that reported in AOM...

..CONCLUSIONS: Early RAOM was more commonly caused by SP if the organism was present in NP at EOT during the initial AOM episode. Most SP-RAOM episodes were caused by SP isolates present in NP at EOT during the previous AOM episode...

..pneumoniae nasopharyngeal and lung colonization and, possibly, pneumonia development in the mouse intranasal inoculation model system. These data indicate that FBA is an S. pneumoniae adhesin and that FCR is its host receptor...

..initially seronegative infants...

..In populations with high carriage rates of S. pneumoniae, critically ill children appear to be at increased risk of pneumococcal sepsis...

..This can be conveniently accomplished by combining acellular pertussis antigens with diphtheria and tetanus toxoids. However the optimal dosage for the booster injection has not yet been determined...

..These drugs may be of potential benefit for the treatment of pneumococcal otitis media, including infections caused by organisms resistant to conventional drugs...

..It was concluded that the optical immunosensor system is an accurate and sensitive method to detect antipneumococcal antibodies and may be an adequate tool to monitor antibodies in specimens such as saliva and urine...

..This study suggests that differential activation or evasion of cytokine expression by S. pneumoniae virulent strains determines disease outcome regardless of the host's immunogenetic background...

..In conclusion, the aim of antimicrobial therapy in respiratory tract infections should be the eradication of the infecting organism...

..Intussusception has been associated with 1 rotavirus vaccine. Our objective was to determine intussusception rates in children in southern Israel during a 15-year period before the introduction of new rotavirus vaccines...

..Results suggest that improving antenatal care and the nutritional status of infants may reduce the risk of CAAP in Bedouin children. Furthermore, they suggest that vaccines developed to prevent diarrhea may also lower the risk of CAAP...

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