Rate of Concurrent Otitis Media in Upper Respiratory Tract Infections With Specific Viruses
Rate of Concurrent Otitis Media in Upper Respiratory Tract Infections With Specific Viruses
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DOI：
10.1001/archotol.135.1.17
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发表时间：
2009-01-01
影响因子：
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通讯作者：
Doyle, William J.
中科院分区：
文献类型：
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作者：
Alper, Cuneyt M.;Winther, Birgit;Doyle, William J.
目的：评价新发中耳炎(OM)与聚合酶链式反应(PCR)首次检测鼻咽部常见病毒的符合性。新的OM发作通常与病毒性上呼吸道感染(VURTI)重合，但关于特定病毒与OM之间的关联，存在相互矛盾的数据。设计：纵向(10-3月)，通过日记对患感冒类疾病(CLI)的儿童进行预期随访，通过气动耳镜观察中耳状况，通过PCR观察vURTI。设置：学术医学中心。参与者：总共102个家庭，至少有2个1-5岁之间的孩子(213个儿童；平均[SD]年龄，3.7[1.5]岁；110名男性；主要观察指标：新的OM和CLI发作以及鼻咽病毒检测。结果：176名儿童(81%)分离到至少1种病毒。检出鼻病毒62例(44%)，呼吸道合胞病毒15例(56%)，甲型流感8例(73%)，乙型流感1例(20%)，腺病毒6例(50%)，冠状病毒7例(39%)，副流感病毒4例(36%)(P=0.37)。对于鼻病毒，新的OM发生在有并发CLI的儿童中的50%和没有并发CLI的儿童中的32%(P=.15)，OM的风险可以通过OM和母乳喂养史以及家庭外的日常环境来预测。结论：无论是否有并发CLI，新的OM与鼻咽中所有检测到的病毒有关。注意到不同病毒之间的差异，但没有达到统计学意义，可能是因为非鼻病毒检测的数量较少，功率较低。
Objective: To estimate the coincidence of new otitis media (OM) for first nasopharyngeal detections of the more common viruses by polymerase chain reaction (PCR). New OM episodes are usually coincident with a viral upper respiratory tract infection (vURTI), but there are conflicting data regarding the association between specific viruses and OM.Design: Longitudinal (October-March), prospective follow-up of children for coldlike illness (CLI) by diary, middle ear status by pneumatic otoscopy, and vURTI by PCR.Setting: Academic medical centers.Participants: A total of 102 families with at least 2 children aged between 1 and 5 years (213 children; mean [SD] age, 3.7 [1.5] years; 110male; and 176white) were recruited from the local communities at 2 study sites by advertisement.Main Outcome Measures: New OM and CLI episodes and nasopharyngeal virus detections.Results: A total of 176 children (81%) had isolated PCR detection of at least 1 virus. The OM coincidence rates were 62 of 144 (44%) for rhinovirus, 15 of 27 (56%) for respiratory syncytial virus, 8 of 11 (73%) and 1 of 5 (20%) for influenza A and B, respectively, 6 of 12 (50%) for adenovirus, 7 of 18 (39%) for coronavirus, and 4 of 11 (36%) for parainfluenza virus detections (P=.37). For rhinovirus, new OM occurred in 50% of children with and 32% without a concurrent CLI (P=.15), and OM risk was predicted by OM and breastfeeding histories and by daily environment outside the home.Conclusions: New OM was associated with nasopharyngeal detection of all assayed viruses irrespective of the presence or absence of a concurrent CLI. Differences among viruses were noted, but statistical significance was not achieved, possibly because of the low power associated with the small number of nonrhinovirus detections.