The prevalence of middle ear pathogens in the outer ear canal and the nasopharyngeal cavity of healthy young adults
The prevalence of middle ear pathogens in the outer ear canal and the nasopharyngeal cavity of healthy young adults
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DOI：
10.1111/j.1469-0691.2009.02928.x
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发表时间：
2010-07-01
影响因子：
14.2
通讯作者：
Dhooge, I.
中科院分区：
文献类型：
--
作者：
De Baere, T.;Vaneechoutte, M.;Dhooge, I.
P>；使用标准技术培养慢性渗出性中耳炎(OME)患儿的中耳液样本，可在约30%-50%的病例中分离出细菌。流感嗜血杆菌、肺炎链球菌和卡他莫拉菌是急性中耳炎的经典中耳致病菌，但最近的一些研究表明，中耳炎异种球菌也是一种新的致病菌。在这项研究中，我们使用物种特异性的PCRS来建立鼻咽腔和外耳中流感嗜血杆菌、卡他支原体、肺炎链球菌和中耳炎杆菌的流行率。研究组为70名健康志愿者(年龄19~22岁)。结果表明，与鼻咽部没有中耳炎相比，外耳有很高的患病率(>；80%)。外耳和鼻咽均发现流感嗜血杆菌(6%和14%)，而肺炎链球菌和卡他支原体仅在鼻咽(9%和34%)发现。作为一种挑剔的微生物，可以通过优化的培养方案进行培养，并延长培养时间，在总共10份PCR阳性样本中，9份样本中有5份能分离到中耳沙门氏菌。鉴于鼻咽部不存在外耳寄生的中耳炎，其在OME病因学中的作用仍不明确，因为中耳感染生物被认为是通过咽鼓管从鼻咽侵入中耳。
P>Culturing middle ear fluid samples from children with chronic otitis media with effusion (OME) using standard techniques results in the isolation of bacterial species in approximately 30-50% of the cases. Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis, the classic middle ear pathogens of acute otitis media, are involved but, recently, several studies suggested Alloiococcus otitidis as an additional pathogen. In the present study, we used species-specific PCRs to establish the prevalence, in both the nasopharyngeal cavity and the outer ear, of H. influenzae, M. catarrhalis, S. pneumoniae and A. otitidis. The study group consisted of 70 healthy volunteers (aged 19-22 years). The results indicate a high prevalence (> 80%) of A. otitidis in the outer ear in contrast to its absence in the nasopharynx. H. influenzae was found in both the outer ear and the nasopharynx (6% and 14%, respectively), whereas S. pneumoniae and M. catarrhalis were found only in the nasopharynx (9% and 34%, respectively).A. otitidis, described as a fastidious organism, were able to be cultured using an optimized culture protocol, with prolonged incubation, which allowed the isolation of A. otitidis in five of the nine PCR-positive samples out of the total of ten samples tested. Given the absence of the outer ear inhabitant A. otitidis from the nasopharynx, its role in the aetiology of OME remains ambiguous because middle ear infecting organisms are considered to invade the middle ear from the nasopharynx through the Eustachian tube.