Viral-bacterial co-infection in Australian Indigenous children with acute otitis media

BMC Infectious Diseases

Research Article

Joseph McDonnell¹  Amanda J Leach¹  Michael J Binks¹  Heidi Smith-Vaughan¹  Allen C Cheng²  Michael Nissen³  Theo Sloots³  David Whiley³ 

[1] Ear and Respiratory Unit, Child Health Division, Menzies School of Health Research, Charles Darwin University, 0810, Darwin, Australia;Ear and Respiratory Unit, Child Health Division, Menzies School of Health Research, Charles Darwin University, 0810, Darwin, Australia;Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Monash University, 3800, Melbourne, Australia;Queensland Paediatric Infectious Diseases Laboratory, Sir Albert Sakzewski Virus Research Centre, Royal Children's Hospital, 4029, Brisbane, Australia;

关键词: Respiratory Syncytial Virus;    Otitis Medium;    Acute Otitis Medium;    Bacterial Load;    Eustachian Tube;   

DOI  :  10.1186/1471-2334-11-161

 received in 2011-02-03, accepted in 2011-06-07,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAcute otitis media with perforation (AOMwiP) affects 40% of remote Indigenous children during the first 18 months of life. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the primary bacterial pathogens of otitis media and their loads predict clinical ear state. Our hypothesis is that antecedent respiratory viral infection increases bacterial density and progression to perforation.MethodsA total of 366 nasopharyngeal swabs from 114 Indigenous children were retrospectively examined. A panel of 17 respiratory viruses was screened by PCR, and densities of S. pneumoniae, H. influenzae and M. catarrhalis were estimated by quantitative real time PCR. Data are reported by clinical ear state.ResultsM. catarrhalis (96%), H. influenzae (91%), S. pneumoniae (89%) and respiratory viruses (59%) were common; including rhinovirus (HRV) (38%), polyomavirus (HPyV) (14%), adenovirus (HAdV) (13%), bocavirus (HBoV) (8%) and coronavirus (HCoV) (4%). Geometric mean bacterial loads were significantly higher in children with acute otitis media (AOM) compared to children without evidence of otitis media. Children infected with HAdV were 3 times more likely (p < 0.001) to have AOM with or without perforation.ConclusionThis study confirms a positive association between nasopharyngeal bacterial load and clinical ear state, exacerbated by respiratory viruses, in Indigenous children. HAdV was independently associated with acute ear states.

【 授权许可】

CC BY   
© Binks et al; licensee BioMed Central Ltd. 2011