Microbiology of acute otitis media in children with tympanostomy tubes:: Prevalences of bacteria and viruses
Microbiology of acute otitis media in children with tympanostomy tubes:: Prevalences of bacteria and viruses
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DOI：
10.1086/509332
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发表时间：
2006-12-01
影响因子：
11.8
通讯作者：
Ruuskanen, Olli
中科院分区：
文献类型：
--
作者：
Ruohola, Aino;Meurman, Olli;Ruuskanen, Olli
背景在50%-90%的伴有或不伴有耳炎的急性中耳炎（AOM）病例中发现了细菌，在20%-49%的病例中发现了病毒。然而，对于至少15%的AOM患者，微生物病因从未确定。我们的目的是通过使用现代微生物学方法同时进行细菌和病毒检测来详细说明急性中耳感染的全部病因。研究对象为79名患有AOM的幼儿，新发（< 48 h）耳畸形通过鼓膜造孔管。通过鼓膜造口管从中耳抽吸中耳液样品。通过培养和聚合酶链反应寻找细菌;通过培养、抗原检测和聚合酶链反应分析病毒。在76名儿童（96%）中观察到至少1种呼吸道病原体。73例（92%）发现细菌，55例（70%）发现病毒。52例（66%）患者同时检出细菌和病毒，其中86%的患者检出AOM典型细菌。小核糖核酸病毒占所有病毒发现的60%。在绝大多数儿童中，AOM是细菌和病毒的合并感染。鼓膜造口管未闭并不改变AOM的病原体谱。几乎在所有病例中都可以确定微生物病因。
Background. Bacteria are found in 50%-90% of cases of acute otitis media (AOM) with or without otorrhea, and viruses are found in 20%-49% of cases. However, for at least 15% of patients with AOM, the microbiological etiology is never determined. Our aim was to specify the full etiology of acute middle ear infection by using modern microbiological methods concomitantly for bacterial and viral detection.Methods. The subjects were 79 young children having AOM with new onset (< 48 h) of otorrhea through a tympanostomy tube. Middle ear fluid samples were suctioned from the middle ear through the tympanostomy tube. Bacteria were sought by culture and polymerase chain reaction; viruses were analyzed by culture, antigen detection, and polymerase chain reaction.Results. At least 1 respiratory tract pathogen was noted in 76 children (96%). Bacteria were found in 73 cases (92%), and viruses were found in 55 (70%). In 52 patients (66%), both bacteria and viruses were found. Bacteria typical of AOM were detected in 86% of patients. Picornaviruses accounted for 60% of all viral findings.Conclusions. In the great majority of children, AOM is a coinfection with bacteria and viruses. The patent tympanostomy tube does not change the spectrum of causative agents in AOM. A microbiological etiology can be established in practically all cases.