Michael Pichichero

Summary

Publications

  1. ncbi request reprint Challenges in vaccination of neonates, infants and young children
    Michael E Pichichero
    Rochester General Hospital Research Institute, Rochester, NY 14621, United States of America Electronic address
    Vaccine 32:3886-94. 2014
  2. pmc Nasopharyngeal bacterial interactions in children
    Qingfu Xu
    University Medical Center, Utrecht, The Netherlands
    Emerg Infect Dis 18:1738-45. 2012
  3. pmc Reducing the frequency of acute otitis media by individualized care
    Michael E Pichichero
    Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester NY 14621, USA
    Pediatr Infect Dis J 32:473-8. 2013
  4. doi request reprint Otitis media
    Michael E Pichichero
    Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester General Hospital, Rochester, NY 14621, USA
    Pediatr Clin North Am 60:391-407. 2013
  5. pmc Antibody response to Streptococcus pneumoniae proteins PhtD, LytB, PcpA, PhtE and Ply after nasopharyngeal colonization and acute otitis media in children
    Michael E Pichichero
    Rochester General Hospital Research Institute, Rochester, NY, USA
    Hum Vaccin Immunother 8:799-805. 2012
  6. ncbi request reprint Variations in amoxicillin pharmacokinetic/pharmacodynamic parameters may explain treatment failures in acute otitis media
    Michael E Pichichero
    Rochester General Research Institute, Legacy Pediatric Group, Rochester, New York, USA
    Paediatr Drugs 11:243-9. 2009
  7. pmc Mercury levels in premature and low birth weight newborn infants after receipt of thimerosal-containing vaccines
    Michael E Pichichero
    University of Rochester, Rochester, NY, USA
    J Pediatr 155:495-9. 2009
  8. pmc Antibody response to Haemophilus influenzae outer membrane protein D, P6, and OMP26 after nasopharyngeal colonization and acute otitis media in children
    Michael E Pichichero
    Rochester General Hospital Research Institue, 1425 Portland Avenue, Rochester, NY 14621, USA
    Vaccine 28:7184-92. 2010
  9. ncbi request reprint Booster vaccinations: can immunologic memory outpace disease pathogenesis?
    Michael E Pichichero
    Rochester General Research Institute, Rochester General Hospital, Rochester, New York 14621, USA
    Pediatrics 124:1633-41. 2009
  10. pmc Haemophilus influenzae vaccine candidate outer membrane protein P6 is not conserved in all strains
    Arthur Chang
    Rochester General Hospital, Rochester General Research Institute, Center for Infectious Diseases and Immunology, Rochester, NY, USA
    Hum Vaccin 7:102-5. 2011

Research Grants

  1. NTHi Immunity in Young Children
    Michael E Pichichero; Fiscal Year: 2010
  2. NTHi Immunity in Young Children
    Michael Pichichero; Fiscal Year: 2009
  3. NTHi Immunity in Young Children
    Michael Pichichero; Fiscal Year: 2009
  4. NTHi Immunity in Young Children
    Michael Pichichero; Fiscal Year: 2009

Collaborators

Detail Information

Publications51

  1. ncbi request reprint Challenges in vaccination of neonates, infants and young children
    Michael E Pichichero
    Rochester General Hospital Research Institute, Rochester, NY 14621, United States of America Electronic address
    Vaccine 32:3886-94. 2014
    ..The discussion will address vaccine responses with respect to four areas: (1) systemic antibody responses, (2) memory B-cell generation, (3) CD4 T-cell responses, and (4) APC function. ..
  2. pmc Nasopharyngeal bacterial interactions in children
    Qingfu Xu
    University Medical Center, Utrecht, The Netherlands
    Emerg Infect Dis 18:1738-45. 2012
    ..Bacterial interactions result in differing pathogen prevalence during periods of health and at onset of AOM. H. influenzae might become a more common cause of AOM among children who receive pneumococcal conjugate vaccine...
  3. pmc Reducing the frequency of acute otitis media by individualized care
    Michael E Pichichero
    Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester NY 14621, USA
    Pediatr Infect Dis J 32:473-8. 2013
    ....
  4. doi request reprint Otitis media
    Michael E Pichichero
    Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester General Hospital, Rochester, NY 14621, USA
    Pediatr Clin North Am 60:391-407. 2013
    ..Antibiotic prophylaxis has fallen into disfavor as a preventative strategy for AOM recurrences...
  5. pmc Antibody response to Streptococcus pneumoniae proteins PhtD, LytB, PcpA, PhtE and Ply after nasopharyngeal colonization and acute otitis media in children
    Michael E Pichichero
    Rochester General Hospital Research Institute, Rochester, NY, USA
    Hum Vaccin Immunother 8:799-805. 2012
    ....
  6. ncbi request reprint Variations in amoxicillin pharmacokinetic/pharmacodynamic parameters may explain treatment failures in acute otitis media
    Michael E Pichichero
    Rochester General Research Institute, Legacy Pediatric Group, Rochester, New York, USA
    Paediatr Drugs 11:243-9. 2009
    ..These findings suggest that variability in PK/PD parameters may impact amoxicillin concentrations in serum and MEF, possibly explaining some AOM treatment failures...
  7. pmc Mercury levels in premature and low birth weight newborn infants after receipt of thimerosal-containing vaccines
    Michael E Pichichero
    University of Rochester, Rochester, NY, USA
    J Pediatr 155:495-9. 2009
    ....
  8. pmc Antibody response to Haemophilus influenzae outer membrane protein D, P6, and OMP26 after nasopharyngeal colonization and acute otitis media in children
    Michael E Pichichero
    Rochester General Hospital Research Institue, 1425 Portland Avenue, Rochester, NY 14621, USA
    Vaccine 28:7184-92. 2010
    ..For all 3 proteins serum antibody levels in the convalescent phase of AOM infection were not as high as after NP colonization. Antibodies to protein D and P6 but not OMP26 were bactericidal...
  9. ncbi request reprint Booster vaccinations: can immunologic memory outpace disease pathogenesis?
    Michael E Pichichero
    Rochester General Research Institute, Rochester General Hospital, Rochester, New York 14621, USA
    Pediatrics 124:1633-41. 2009
    ..With infectious diseases for which the pace of pathogenesis is slow, immune memory should be sufficient to prevent disease...
  10. pmc Haemophilus influenzae vaccine candidate outer membrane protein P6 is not conserved in all strains
    Arthur Chang
    Rochester General Hospital, Rochester General Research Institute, Center for Infectious Diseases and Immunology, Rochester, NY, USA
    Hum Vaccin 7:102-5. 2011
    ..These results show that NTHi omp P6 is not invariant in its structure among respiratory isolates from children...
  11. doi request reprint Mercury levels in newborns and infants after receipt of thimerosal-containing vaccines
    Michael E Pichichero
    Department of Microbiology Immunology, Pediatrics, and Medicine, University of Rochester, Rochester, New York 14642, USA
    Pediatrics 121:e208-14. 2008
    ..We conducted a pharmacokinetic study to assess blood levels and elimination of ethyl mercury after vaccination of infants with thimerosal-containing vaccines...
  12. pmc Transcriptome signature in young children with acute otitis media due to Streptococcus pneumoniae
    Keyi Liu
    Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, 1425 Portland Avenue, Rochester, NY 14621, USA
    Microbes Infect 14:600-9. 2012
    ..In contrast, genes associated with cell-mediated immune responses were broadly down-regulated. The results provide the first human transcriptome data identifying genes differentially regulated at the onset of AOM in children...
  13. pmc Haemophilus influenzae outer membrane protein P6 molecular characterization may not differentiate all strains of H. Influenzae from H. haemolyticus
    Arthur Chang
    Rochester General Hospital, Rochester General Research Institute, Center for Infectious Diseases and Immunology, Rochester, NY 14621, USA
    J Clin Microbiol 48:3756-7. 2010
    ..Further testing using RapID NH and multilocus sequence analysis may not help identify some isolates. Translated OMP P6 gene sequences are not conserved among all isolates presumed to be H. influenzae...
  14. ncbi request reprint Mercury concentrations and metabolism in infants receiving vaccines containing thiomersal: a descriptive study
    Michael E Pichichero
    Department of Microbiology Immunology, University of Rochester, Rochester, New York, NY, USA
    Lancet 360:1737-41. 2002
    ..We aimed to measure concentrations of mercury in blood, urine, and stools of infants who received such vaccines...
  15. pmc Serum intercellular adhesion molecule 1 variations in young children with acute otitis media
    Keyi Liu
    Rochester General Research Institute, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621, USA
    Clin Vaccine Immunol 17:1909-16. 2010
    ..We conclude that AOM often causes a systemic inflammatory reaction, as measured by elevation of the serum sICAM-1 level, and that a high variability in sICAM-1 responses occurs with the presence of otopathogens during AOM...
  16. ncbi request reprint Otitis media
    Michael E Pichichero
    Elmwood Pediatric Group, University of Rochester Medical Center, Rochester, NY 14642, USA
    Expert Opin Pharmacother 3:1073-90. 2002
    ..Best-practice for management of acute OM continues to advocate antibiotic therapy with careful, accurate diagnosis and consideration of the major pathogens and their mechanisms of resistance...
  17. ncbi request reprint Safety and efficacy of gatifloxacin therapy for children with recurrent acute otitis media (AOM) and/or AOM treatment failure
    Michael E Pichichero
    Elmwood Pediatric Group, University of Rochester Medical Center, Rochester, New York 14642, USA
    Clin Infect Dis 41:470-8. 2005
    ..This study describes the safety and efficacy of gatifloxacin when used for treatment of children with recurrent acute otitis media (ROM) or acute otitis media (AOM) treatment failure (AOMTF)...
  18. ncbi request reprint Changes in frequency and pathogens causing acute otitis media in 1995-2003
    Janet R Casey
    Elmwood Pediatric Group, Department of Pediatrics, University of Rochester, Rochester, NY, USA
    Pediatr Infect Dis J 23:824-8. 2004
    ....
  19. ncbi request reprint Acute otitis media: making sense of recent guidelines on antimicrobial treatment
    Michael E Pichichero
    University of Rochester Medical Center, Elmwood Pediatric Group, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, USA
    J Fam Pract 54:313-22. 2005
    ..Key factors for enhancing compliance are taste of suspension, dosing frequency, and duration of therapy...
  20. pmc Simultaneous assay for four bacterial species including Alloiococcus otitidis using multiplex-PCR in children with culture negative acute otitis media
    Ravinder Kaur
    Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, University of Rochester School of Medicine, Rochester, NY, USA
    Pediatr Infect Dis J 29:741-5. 2010
    ..Conventional culture methods detect these pathogens in only 60% to 70% of cases of AOM. Alloiococcus otitidis, another potential pathogen, has often been ignored...
  21. pmc New patterns in the otopathogens causing acute otitis media six to eight years after introduction of pneumococcal conjugate vaccine
    Janet R Casey
    Department of Pediatrics, University of Rochester, Rochester, NY, USA
    Pediatr Infect Dis J 29:304-9. 2010
    ....
  22. doi request reprint Pathogens causing recurrent and difficult-to-treat acute otitis media, 2003-2006
    Michael E Pichichero
    University of Rochester Medical Center and Legacy Pediatrics, Rochester, New York 14642, USA
    Clin Pediatr (Phila) 47:901-6. 2008
    ..influenzae produced beta-lactamase, respectively. Although H. influenzae remains the most frequently isolated pathogen in children with AOMTF or recurrent AOM, S. pneumoniae that are PNSP are reemerging as important organisms...
  23. ncbi request reprint Frequency of symptomatic relapses of group A beta-hemolytic streptococcal tonsillopharyngitis in children from 4 pediatric practices following penicillin, amoxicillin, and cephalosporin antibiotic treatment
    Janet R Casey
    Legacy Pediatrics, University of Rochester, Rochester, New York, USA
    Clin Pediatr (Phila) 47:549-54. 2008
    ....
  24. doi request reprint Comparison of study designs for acute otitis media trials
    Michael E Pichichero
    University of Rochester, School of Medicine, Department of Microbiology Immunology, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, United States
    Int J Pediatr Otorhinolaryngol 72:737-50. 2008
    ..A framework for evaluating the efficacy of antibiotics in development as well as those currently approved for acute otitis media (AOM) is needed...
  25. ncbi request reprint White blood cell count can aid judicious antibiotic prescribing in acute upper respiratory infections in children
    Janet R Casey
    Elmwood Pediatric Group, Rochester, NY 14642, USA
    Clin Pediatr (Phila) 42:113-9. 2003
    ..With this approach, return office visits in the following 2 weeks were infrequent (13% of 737 patients), and no child had significant bacterial illness that was missed. With selective use of WBC count testing..
  26. ncbi request reprint Evolving microbiology and molecular epidemiology of acute otitis media in the pneumococcal conjugate vaccine era
    Michael E Pichichero
    Department of Microbiology and Immunology, University of Rochester, Rochester, New York 14642, USA urmc rochester edu
    Pediatr Infect Dis J 26:S12-6. 2007
    ..Expansion of the number of serotypes included in pneumococcal conjugate vaccines is needed to sustain a long-term benefit from immunization against these bacteria...
  27. ncbi request reprint Diagnostic inaccuracy and subject exclusions render placebo and observational studies of acute otitis media inconclusive
    Michael E Pichichero
    Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642, USA
    Pediatr Infect Dis J 27:958-62. 2008
    ..Diagnostic accuracy and appropriate inclusion/exclusion criteria representative of children at greatest risk is of paramount importance in trials to evaluate placebo or observation as an option for acute otitis media (AOM) management...
  28. ncbi request reprint Comparison of performance by otolaryngologists, pediatricians, and general practioners on an otoendoscopic diagnostic video examination
    Michael E Pichichero
    Elmwood Pediatric Group, University of Rochester Medical Center, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, USA
    Int J Pediatr Otorhinolaryngol 69:361-6. 2005
    ....
  29. ncbi request reprint Seven-year follow-up of vaccine response in extremely premature infants
    Khaver I Kirmani
    Department of Pediatrics, Strong Children s Research Center, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA
    Pediatrics 109:498-504. 2002
    ..To assess the immune response of 7-year-old former extremely preterm (PT) infants to routine childhood immunizations...
  30. ncbi request reprint Evolving shifts in otitis media pathogens: relevance to a managed care organization
    Michael E Pichichero
    University of Rochester Medical Center, Rochester, NY, USA
    Am J Manag Care 11:S192-201. 2005
    ....
  31. ncbi request reprint Pathogen shifts and changing cure rates for otitis media and tonsillopharyngitis
    Michael E Pichichero
    Department of Microbiology and Immunology, Pediatrics and Medicine, University of Rochester Medical Center, Elmwood Pediatric Group, Rochester, New York 14642, USA
    Clin Pediatr (Phila) 45:493-502. 2006
    ..Recent results with amoxicillin suggest its efficacy is also waning. Cephalosporins have the highest bacteriologic and clinical efficacy. This has implications for optimal antibiotic therapy...
  32. ncbi request reprint Rethinking the total cost of care in AOM and ABS: The impact of improved diagnostic accuracy and antibiotic treatment where high efficacy and adherence are achievable
    Michael E Pichichero
    University of Rochester Medical Center, Elmwood Pediatric Group, 601 Elmwood Ave, Box 672, Rochester, NY 14642, USA
    Am J Manag Care 12:S283-91. 2006
  33. ncbi request reprint A review of recommended antibiotic therapies with impact on outcomes in acute otitis media and acute bacterial sinusitis
    Michael E Pichichero
    University of Rochester Medical Center, Elmwood Pediatric Group, 601 Elmwood Ave, Box 672, Rochester, NY 14642, USA
    Am J Manag Care 12:S292-302. 2006
  34. ncbi request reprint Symptomatic relapse of group A beta-hemolytic streptococcal tonsillopharyngitis in children
    Janet R Casey
    University of Rochester School of Medicine, Elmwood Pediatric Group, Rochester, New York, USA
    Clin Pediatr (Phila) 46:307-10. 2007
    ..02). Clinicians should be aware that the rate of symptomatic failures after antibiotic therapy for group A beta-hemolytic streptococcal tonsillopharyngitis differs by drug and is not an uncommon event...
  35. ncbi request reprint Who should get the HPV vaccine?
    Michael E Pichichero
    Department of Microbiology and Immunology, Pediatrics, and Medicine, University of Rochester Medical Center, Elmood Pediatric Group, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, USA
    J Fam Pract 56:197-202. 2007
  36. ncbi request reprint Impact of a birth dose of hepatitis B vaccine on the reactogenicity and immunogenicity of diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Haemophilus influenzae type b combination vaccination
    Michael E Pichichero
    University of Rochester Medical Center, Rochester, NY 14642, USA
    Pediatr Infect Dis J 21:854-9. 2002
    ....
  37. ncbi request reprint Diagnostic accuracy, tympanocentesis training performance, and antibiotic selection by pediatric residents in management of otitis media
    Michael E Pichichero
    Elmwood Pediatric Group, University of Rochester Medical Center, Rochester, New York 14642, USA
    Pediatrics 110:1064-70. 2002
    ....
  38. ncbi request reprint Efficacy of penicillin vs. amoxicillin in children with group A beta hemolytic streptococcal tonsillopharyngitis
    Correne Curtin-Wirt
    Elmwood Pediatric Group, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
    Clin Pediatr (Phila) 42:219-25. 2003
    ..84, 95% confidence interval 1.02-3.29); the same was true for dinical cure (OR = 1.99, 95% CI = 1.02-3.87). Amoxicillin may be superior to penicillin for bacteriologic and clinical cure of GABHS tonsillopharyngitis...
  39. ncbi request reprint Emergence of a multiresistant serotype 19A pneumococcal strain not included in the 7-valent conjugate vaccine as an otopathogen in children
    Michael E Pichichero
    University of Rochester and Legacy Pediatrics, Rochester, New York, USA
    JAMA 298:1772-8. 2007
    ..Concern has been raised about the possible emergence of a bacterial strain that is untreatable by US Food and Drug Administration (FDA)-approved antibiotics and that causes acute otitis media (AOM) in children...
  40. ncbi request reprint A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients
    Michael E Pichichero
    University of Rochester Medical Center, Elmwood Pediatric Group, 601 Elmwood Ave, Box 672, Rochester, NY 14642, USA
    Pediatrics 115:1048-57. 2005
    ..Specific recommendations for the treatment of patients on the basis of their responses to previously prescribed agents are summarized...
  41. ncbi request reprint Immunogenicity and safety of a combination diphtheria, tetanus toxoid, acellular pertussis, hepatitis B, and inactivated poliovirus vaccine coadministered with a 7-valent pneumococcal conjugate vaccine and a Haemophilus influenzae type b conjugate vaccine
    Michael E Pichichero
    University of Rochester Medical Center, Rochester, New York 14642, USA
    J Pediatr 151:43-9, 49.e1-2. 2007
    ....
  42. ncbi request reprint Preferred antibiotics for treatment of acute otitis media: comparison of practicing pediatricians, general practitioners, and otolaryngologists
    Michael E Pichichero
    Elmwood Pediatric Group, University of Rochester Medical Center, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, USA
    Clin Pediatr (Phila) 44:575-8. 2005
    ..After instruction that provides the rationale for guideline-recommended agents based on pharmacokinetics/pharmacodynamics and double tympanocentesis trials, endorsement of recommended antibiotics significantly improved to >90%...
  43. ncbi request reprint Acellular pertussis vaccine booster combined with diphtheria and tetanus toxoids for adolescents
    Michael E Pichichero
    University of Rochester Medical Center, Rochester, NY 14642, USA
    Pediatrics 117:1084-93. 2006
    ..Recently licensed in the United States for use in adolescents, acellular pertussis vaccines will provide an immunogenic and safe option for booster immunization against pertussis...
  44. ncbi request reprint Prevention of cervical cancer through vaccination of adolescents
    Michael E Pichichero
    Department of Microbiology and Immunology, Pediatrics, and Medicine, University of Rochester Medical Center, Elmwood Pediatric Group, Rochester, New York 14642, USA
    Clin Pediatr (Phila) 45:393-8. 2006
  45. ncbi request reprint Systematic review of factors contributing to penicillin treatment failure in Streptococcus pyogenes pharyngitis
    Michael E Pichichero
    University of Rochester Medical Center, Rochester, NY 14642, USA
    Otolaryngol Head Neck Surg 137:851-857. 2007
    ..Review the evidence for various explanations for microbiologic treatment failure following use of penicillin in group A streptococcal (GAS) tonsillopharyngitis...
  46. doi request reprint Probability of achieving requisite pharmacodynamic exposure for oral beta-lactam regimens against Haemophilus influenzae in children
    Michael E Pichichero
    Department of Microbiology and Immunology, University of Rochester, Rochester, New York 14642, USA
    Paediatr Drugs 10:391-7. 2008
    ..influenzae isolates using Monte Carlo simulation...
  47. pmc Novel type of Streptococcus pneumoniae causing multidrug-resistant acute otitis media in children
    Qingfu Xu
    University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
    Emerg Infect Dis 15:547-51. 2009
    ..pneumoniae in which all strains had 6 of the same alleles as ST-156. The multidrug-resistant strains related to ST-156 expressed different capsular serotypes: 9V, 14, 11A, 15C, and 19F...
  48. pmc Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6
    Albert Sabirov
    Department of Microbiology Immunology, University of Rochester, Rochester, New York 14627, USA
    Pediatr Res 66:565-70. 2009
    ..Higher serum IgG might facilitate protection against AOM and NP colonization in breast-fed children...
  49. ncbi request reprint Acellular pertussis vaccine boosters combined with diphtheria and tetanus toxoid boosters for adolescents: safety and immunogenicity assessment when preceded by different 5-dose DTaP/DTwP schedules
    Michael E Pichichero
    Microbiology and Immunology, Pediatrics and Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, USA
    Clin Pediatr (Phila) 45:613-20. 2006
    ..Seroprotective levels and antibody concentrations were comparable regardless of prior DTaP/DTwP vaccine history. A sixth sequential dose of Tdap after 5 doses of DTaP appears safe and immunogenic...
  50. ncbi request reprint Prospective identification and treatment of children with pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS)
    Marie Lynd Murphy
    Elmwood Pediatric Group, University of Rochester Medical Center, 601 Elmwood Ave, Box 672, Rochester, NY 14642, USA
    Arch Pediatr Adolesc Med 156:356-61. 2002
    ....

Research Grants4

  1. NTHi Immunity in Young Children
    Michael E Pichichero; Fiscal Year: 2010
    ..The results gained from these studies will provide insight to the immune mechanisms involved in the pathogenesis of otitis media aid in the development of a vaccine for otits media. ..
  2. NTHi Immunity in Young Children
    Michael Pichichero; Fiscal Year: 2009
    ..The results gained from these studies will provide insight to the immune mechanisms involved in the pathogenesis of otitis media aid in the development of a vaccine for otits media. ..
  3. NTHi Immunity in Young Children
    Michael Pichichero; Fiscal Year: 2009
    ..The results gained from these studies will provide insight to the immune mechanisms involved in the pathogenesis of otitis media aid in the development of a vaccine for otits media. ..
  4. NTHi Immunity in Young Children
    Michael Pichichero; Fiscal Year: 2009
    ..The results gained from these studies will provide insight to the immune mechanisms involved in the pathogenesis of otitis media aid in the development of a vaccine for otits media. ..