Presence of respiratory viruses in middle ear fluids and nasal wash specimens from children with acute otitis media.
Presence of respiratory viruses in middle ear fluids and nasal wash specimens from children with acute otitis media.
复制标题
急性中耳炎儿童的中耳液和鼻洗液标本中存在呼吸道病毒。
作者：
T. Chonmaitree;V. M. Howie;Allan L. Truant
对84例急性中耳炎患儿进行了28个月的中耳液病毒、细菌培养和鼻灌洗液病毒培养。从17例（20%）患者的中耳液中分离出病毒。33例（39%）患者的中耳液和/或鼻灌洗液病毒培养阳性证实了病毒感染的证据。鼻病毒在一个病人和流感B病毒在另一个是唯一的病原体分离。流行性感冒病毒、肠病毒和鼻病毒是中耳液中最常见的病毒。副流感病毒、腺病毒和呼吸道合胞病毒较少被发现。在82%的病例中，从中耳液中分离的病毒也从鼻灌洗液中分离出来，但只有44%的鼻灌洗液中发现的病毒也在中耳液中发现。混合细菌感染和病毒-细菌联合感染很常见。只有15%的患者没有从中耳液中分离出病原体。利用组织培养技术，我们证明肠道病毒和鼻病毒也是常见的中耳病原体。我们的数据再次强调了病毒作为急性中耳炎病原体的重要性，并提出了有关病毒-细菌相互作用和参与疾病发病机制的病毒类型的几个问题。
During a 28-month period, 84 children with acute otitis media were studied by viral and bacterial cultures of middle ear fluid and viral cultures of nasal lavage fluid. Viruses were isolated from the middle ear fluid of 17 (20%) patients. Evidence of viral infection was demonstrated by positive viral cultures of middle ear fluid and/or nasal lavage fluid in 33 (39%) patients. Rhinovirus in one patient and influenza b virus in another were the only pathogens isolated. Influenza virus, enterovirus, and rhinovirus were the most common viruses found in middle ear fluids. Parainfluenza virus, adenovirus, and respiratory syncytial virus were found less often. In 82% of cases, the virus isolated from middle ear fluid was also isolated from nasal lavage fluid, but only 44% of viruses found in nasal lavage fluid were also found in middle ear fluid. Mixed bacterial and combined viral-bacterial infections were common. Only 15% of patients had no pathogen isolated from middle ear fluids. Using tissue culture techniques, we demonstrated that enterovirus and rhinovirus are also common middle ear pathogens. Our data reemphasize the significance of viruses as etiologic agents of acute otitis media and propose several questions regarding the viral-bacterial interactions and the types of viruses involved in the pathogenesis of the disease.