Otitis media in Indigenous and non-Indigenous children: microbiological and immunological risk factors

中耳炎(中耳感染)是儿童的主要健康问题。许多儿童反复发作，需要频繁使用抗生素，一些需要手术，一些遭受严重后果，特别是听力损失。这可能会影响在学校的表现，从而影响成年后的就业和社会环境。土著儿童的发病率比非土著儿童高得多，并发症也更多。许多因素导致了沉重的疾病负担。在卡尔古利-博尔德地区，我们正在跟踪土著和非土著儿童从出生到24个月的情况，研究各种因素，以便尽快实施适当的干预方案。从鼻子后面采集样本，以找出携带一系列细菌或病毒与患中耳炎风险之间的关系。有关我们分离的细菌的抗生素耐药性的信息将有助于确保中耳炎的适当治疗。我们还收集了母亲的母乳样本和几个唾液样本，以了解婴儿的免疫系统及其与疾病的关系，以协助正在进行的预防中耳炎的疫苗开发计划。我们将找出拥挤或被动吸烟等环境因素与细菌携带的关系，以及不同因素的组合是否会增加患病风险。最近在澳大利亚获得许可的一种名为肺炎球菌结合疫苗的新疫苗，在预防肺炎和脑膜炎等严重疾病方面非常有效，并对耳朵感染提供了一些保护。它很可能首先提供给土著儿童，因为他们患肺炎球菌病的比率很高。疫苗可能会改变鼻子里的细菌类型。需要仔细监测这一点，这在本研究期间是可能的。

Otitis media (middle ear infections) is a major health problem in children. Many children suffer repeated attacks requiring frequent courses of antibiotics, some need surgery and some suffer serious consequences, particularly hearing loss. This can affect performance at school, hence employment and social circumstances in adulthood. Indigenous children suffer much higher rates of disease with more complications than non-Indigenous children. Many factors predispose to the heavy burden of disease. In the Kalgoorlie-Boulder area we are following Indigenous and non-Indigenous children from birth to 24 months to look at a broad range of factors in order to proceed as soon as possible to appropriate intervention programs. Samples from the back of the nose are collected to find out the relationship between carriage of a range of bacteria or viruses and risk of getting otitis media. Information on antibiotic resistance of the bacteria we isolate will assist in ensuring appropriate treatment of otitis media. We also collect a sample of breast milk from mothers and several samples of saliva to find out about the immune system of babies and how this relates to disease to assist in an ongoing program of vaccine development for prevention of otitis media. We will find out how environmental factors such as crowding or passive smoking relate to carriage of bacteria and whether a combination of different factors increase risk of disease. A new vaccine called pneumococcal conjugate vaccine, recently licensed in Australia, is highly effective in preventing severe diseases such as pneumonia and meningitis and affords some protection against ear infections. It is likely to be offered first to Indigenous children because they suffer very high rates of pneumococcal disease. The vaccine may alter the types of bacteria in the nose. This needs to be monitored carefully which will be possible during this study.