{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:56:07Z","timestamp":1790812567953,"version":"4.1.0"},"reference-count":51,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Acute otitis media (AOM) is a common disease among children and can be complicated by otorrhea (AOMO). In 2010, the 13-valent Pneumococcal Conjugate Vaccine (PCV13) replaced the 7-valent vaccine (PCV7) in Greece. We aimed to describe the microbiological profile of bacterial \u0391OMO among children younger than 16 years across the two PCV periods in a tertiary children\u2019s hospital. Middle ear fluid cultures from 2418 children with AOMO were collected from 2007 to 2022. Otopathogens were isolated and tested for antimicrobial susceptibility. Data were compared between the PCV7- (2007\u20132011) and PCV13-period (2012\u20132019). The most common otopathogen over the 16-year period was S. pyogenes (35.4%), followed by H. influenzae (33.8%), S. pneumoniae (26.6%), and M. catarrhalis (4.1%). Pneumococcal resistance to cefotaxime and clindamycin significantly increased from 2% to 4.5% (p = 0.019) and 16.1% to 22.8% (p = 0.039), respectively. Resistance of H. influenzae to ampicillin increased from 6.3% to 13.9% (p &lt; 0.001). A significant reduction in cotrimoxazole-resistant S. pneumoniae from 31% to 22.4% (p = 0.012), and in clindamycin-resistant and erythromycin-resistant S pyogenes, from 17.4% to 9.3% and 21.4% to 10.8%, respectively (p \u2264 0.001), was observed. During 2013\u20132022, 38 S. pneumoniae serotypes were identified among 250 isolates. Serotype 3 (27.2%) and 19A (13.2%) prevailed, followed by 19F (7%). The most common causes after the shift to PCV13 are S. pyogenes and H. influenzae. However, S. pneumoniae remains an important otopathogen with significant antimicrobial resistance. Serotype 3 was mostly detected, followed by 19A.<\/jats:p>","DOI":"10.3390\/pathogens14050494","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T07:34:03Z","timestamp":1747640043000},"page":"494","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bacterial Acute Otitis Media Complicated with Otorrhea in a Children\u2019s Hospital in the Era of Pneumococcal Conjugate Vaccines"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6503-4226","authenticated-orcid":false,"given":"Irene","family":"Tzovara","sequence":"first","affiliation":[{"name":"First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, \u201cAghia Sophia\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-5896","authenticated-orcid":false,"given":"Anastasios","family":"Doudoulakakis","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Kalogeras","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Koutouzis","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, \u201cAghia Sophia\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charilaos","family":"Dellis","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, \u201cAghia Sophia\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Pasparakis","sequence":"additional","affiliation":[{"name":"Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marietta","family":"Charakida","sequence":"additional","affiliation":[{"name":"Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2069-9416","authenticated-orcid":false,"given":"Evangelia","family":"Lebessi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisavet","family":"Bozavoutoglou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tsakanikos","sequence":"additional","affiliation":[{"name":"Ear Nose and Throat Department, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0592-9591","authenticated-orcid":false,"given":"Vassiliki","family":"Syriopoulou","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, \u201cAghia Sophia\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2485-4409","authenticated-orcid":false,"given":"Maria","family":"Tsolia","sequence":"additional","affiliation":[{"name":"Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, \u201cP. & A. Kyriakou\u201d Children\u2019s Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Todberg, T., Koch, A., Andersson, M., Olsen, S.F., Lous, J., and Hom\u00f8e, P. (2014). Incidence of Otitis Media in a Contemporary Danish National Birth Cohort. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0111732"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S1473-3099(10)70012-8","article-title":"Otitis Media and Its Consequences: Beyond the Earache","volume":"10","author":"Vergison","year":"2010","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1007\/s00431-003-1260-5","article-title":"The Burden of Acute Otitis Media on the Patient and the Family","volume":"162","author":"Greenberg","year":"2003","journal-title":"Eur. J. 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