Pneumonia, Sinusitis, Influenza and Other Respiratory Illnesses in Acute Otitis Media-Prone Children.
Pneumonia, Sinusitis, Influenza and Other Respiratory Illnesses in Acute Otitis Media-Prone Children.
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肺炎，鼻窦炎，流感和其他呼吸道疾病，急性中耳炎的儿童。
DOI：
10.1097/inf.0000000000003228
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发表时间：
2021-11-01
期刊：
影响因子：
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通讯作者：
Bajorski P
中科院分区：
文献类型：
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作者：
Pichichero ME;Chapman TJ;Bajorski P
在生命的最初几年中复发的急性中耳炎（AOM）可以通过免疫功能障碍来解释。因此，预计易患耳炎（OP）的儿童将更容易感染其他传染病，特别是呼吸道感染，因为免疫问题的一个组成部分涉及鼻咽先天免疫。一项队列研究，前瞻性识别6个月至5岁儿童中所有经医生诊断、医疗护理的呼吸系统疾病访视，以确定OP与非耳炎易感（NOP）儿童相比肺炎、急性鼻窦炎、流感和其他细菌和病毒感染的发生率。鼓室穿刺术以微生物学确认AOM疾病。研究了285名儿童。39例符合标准定义的严格定义的易发性中耳炎OP（通过鼓室穿刺术确定），246例为非易发性中耳炎（NOP）。与NOP儿童相比，sOP儿童的推定呼吸道感染频率增加：肺炎（高6倍，p<0.001），鼻窦炎（高2.1倍，p=0.026），流感（高2.9倍，p=0.002）。sOP和NOP儿童在6-18个月时所有呼吸道感染疾病访视的人口统计学和风险因素协变量校正倍数差异为2.4倍（p< 0.00001），18-30个月时为2.2倍，p< 0.00001，30-42个月时为2.4倍，p=0.035）。对于sOP和NOP儿童，6-18个月大的呼吸道感染疾病就诊频率更高，预示着18-60个月大的呼吸道感染疾病就诊频率更高。临床医生应该意识到，在易患耳炎的儿童中，细菌和病毒呼吸道感染倾向的可能性显著增加。
Recurrent acute otitis media (AOM) in the first years of life can be explained by immune dysfunction. Consequently, it would be expected that otitis prone (OP) children would be more susceptible to other infectious diseases, especially respiratory infections since a component of the immune problem involves nasopharyngeal innate immunity. Cohort study with prospective identification of all physician-diagnosed, medically-attended respiratory illness visits in children age 6 months to 5 years of age to determine the incidence of pneumonia, acute sinusitis, influenza and other bacterial and viral infections among OP compared to non-otitis prone (NOP) children. Tympanocentesis to microbiologically confirm AOM disease. 285 children were studied. 39 met a standard definition of stringently defined otitis prone (s)OP determined by tympanocentesis and 246 were non-otitis prone (NOP). sOP children had increased frequency of presumptive respiratory infections: pneumonia (6-fold higher, p<0.001), sinusitis (2.1-fold higher, p=0.026), influenza (2.9-fold higher, p=0.002) compared to NOP children. Demographic and risk factor covariate adjusted fold difference between sOP and NOP children for all respiratory infection illness visits at age 6–18 months was 2.4-fold (p< 0.00001), at 18–30 months was 2.2-fold, p< 0.00001 and at age 30–42 months was 2.4- fold, p=0.035) higher. For both sOP and NOP children, more frequent medically-attended respiratory infection illness visits from 6–18 months of age predicted more frequent visits experienced from 18–60 months of age. Clinicians should be aware of a significant increased likelihood of bacterial and viral respiratory infection proneness among otitis prone children.