There are also multidrug-resistant pathogens among streptococci. Picture:
Read aloud Since the introduction of a middle ear inflammation vaccine in 2000, a resistant pathogen has developed in the US that is no longer responsive to any of the conventional antibiotics. It is a strain of the bacterium Streptococcus pneumoniae, which in addition to middle ear infections also other infections, such as meningitis or pneumonia can cause. He was discovered by American physicians with nine children who, despite being vaccinated, were diagnosed with a middle ear infection. Otitis media is the most common bacterial disease in children and can be caused by various types of bacteria. Among the most common is Streptococcus pneumoniae, of which different strains are known. The disease is usually treated with antibiotics, but this leads to an increasing number of resistant pathogens. For a few years, there is also the possibility of vaccination already for small children. In the US, the introduction of the vaccine called PCV7 reduced the incidence of the infection, while also acting against antibiotic-resistant strains. Since then, the number of new cases in the US has fallen by 20 percent, and the duration and number of new cases have also decreased.

Since the introduction of vaccines is often associated with alterations of the pathogens, Pichicherio and Casey now examined whether such modifications are now also in Streptococcus pneumoniae. In 9 out of 59 children infected with the bacteria, they discovered a pathogen of altered genotype that was resistant to all antibiotics approved for acute middle ear infections in the United States. Although the number of diseases caused by the antibiotic-resistant pathogen is quite low, the results of the study are worrying, the researchers say. Developing an improved vaccine would therefore be needed sooner than expected.

PCV7 is also approved in many European countries, including Germany. Since 2005, the vaccine is recommended by the Standing Vaccination Commission (STIKO) of the Robert Koch Institute. In the meantime, various clinical studies are already in progress on new vaccines that cover seven eleven or even thirteen pathogen variants instead of seven.

Michael Pichicherio, Janet Casey (University of Rochester, New York): JAMA, volume 298, page 1772 ddp / Gesa Graser display


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