Abstract
ObjectivesTo evaluate the presence of viruses and bacteria in middle ear and adenoids of patients with and without otitis media with effusion (OME).MethodsAdenoid samples and middle ear washes (MEW) were obtained from children with OME associated with adenoid hypertrophy undergoing adenoidectomy and tympanostomy, and compared to those obtained from patients undergoing cochlear implant surgery, as a control group. Specific DNA or RNA of 9 respiratory viruses (rhinovirus, influenza virus, picornavirus, syncytial respiratory virus, metapneumovirus, coronavirus, enterovirus, adenovirus and bocavirus) and 5 bacteria (S. pneumoniae, H. influenzae, M. catarrhalis, P. aeruginosa and S. aureus) were extracted and quantified by real-time PCR.Results37 OME and 14 cochlear implant children were included in the study. At the adenoid, virus and bacteria were similarly detected in both OME and control patients. At the middle ear washes, however, a higher prevalence of bacteria was observed in patients with OME (p = 0.01). S. pneumoniae (p = 0.01) and M. catarrhalis (p = 0.022) were the bacteria responsible for this difference. Although total virus detection was not statistically different from controls at the middle ear washes (p = 0.065), adenovirus was detected in higher proportions in adenoid samples of OME patients than controls (p = 0.019).ConclusionsDespite both OME and control patients presented similar rates of viruses and bacteria at the adenoid, children with OME presented higher prevalence of S. pneumonia, M. catarrhalis in middle ear and adenovirus in adenoids when compared to controls. These findings could suggest that these pathogens could contribute to the fluid persistence in the middle ear.
Highlights
Otitis media with effusion (OME) is a common childhood disease characterized by the presence of fluid in the middle ear, with no symptoms and/or signs of acute inflammation [1, 2]
Virus and bacteria were detected in both OME and control patients
At the middle ear washes, a higher prevalence of bacteria was observed in patients with OME (p = 0.01)
Summary
Otitis media with effusion (OME) is a common childhood disease characterized by the presence of fluid in the middle ear, with no symptoms and/or signs of acute inflammation [1, 2]. In the United States, approximately 90% of all children develop an episode of OME before they reach school age, mainly between the ages of 4 months and 6 years [2]. The presence of OME is associated with severe negative impact on child development, including hearing loss with long-term consequences for speech and language acquisition, poor school performance, and imbalance issues [1,2,3]. Children with OME are five times more susceptible to develop acute otitis media than controls [4, 5]. It is widely accepted that the dysfunction of the Eustachian tube play a key role in the development of OME in all ages
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