Bacterial Reservoirs in the Middle Ear of Otitis-prone Children Are Associated With Repeat Ventilation Tube Insertion
| Autor: | Elke J. Seppanen, Harvey Coates, Karli J. Corscadden, Peter Richmond, Selma P. Wiertsema, Hannah J.D. North, Ruth B. Thornton, Peter Jacoby, Shyan Vijayasekaran, Lea Ann S. Kirkham |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Ear Middle medicine.disease_cause Haemophilus influenzae Recurrence Risk Factors Internal medicine Ventilation tube Humans Medicine Otitis Media with Effusion business.industry Infant Odds ratio Middle Ear Ventilation Confidence interval Anti-Bacterial Agents Otitis Media Streptococcus pneumoniae Infectious Diseases Otitis medicine.anatomical_structure Otorhinolaryngology Child Preschool Pediatrics Perinatology and Child Health Middle ear Respiratory virus Female medicine.symptom business |
| Zdroj: | Pediatric Infectious Disease Journal. 39:91-96 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0000000000002541 |
| Popis: | BACKGROUND Repeat ventilation tube insertion (VTI) is common in children with recurrent acute otitis media (rAOM). Identifying risk factors associated with repeat surgery will improve clinical management and prevent repeat VTI. METHODS Surgical records were assessed at 8 years following VTI surgery for rAOM in children 6-36 months of age. Children were grouped according to detection of bacterial otopathogen in their middle ear effusion (MEE) at the time of VTI, and outcomes for future otorhinolaryngology surgery compared. RESULTS Age, gender, pneumococcal vaccination status, antibiotic usage, day-care attendance, number of siblings and number of AOM episodes were similar between groups. Of the 63 children who had PCR +ve MEE, 58.7% required repeat VTI compared with 31.4% of the 51 children with no otopathogen detected in their MEE (odds ratio = 3.1, 95% confidence interval [1.4-6.8]; P = 0.004). Nontypeable Haemophilus influenzae (NTHi) was the predominant otopathogen in MEE (79% of all PCR +ve MEE). Respiratory virus detection was not associated with repeat VTI. CONCLUSIONS Presence of bacterial otopathogen, specifically nontypeable H. influenzae, in the middle ear during VTI was a predictor of children at-risk of repeat VTI. Here, we identify a modifiable microbiologic factor for repeat VTI that can be targeted to improve clinical management of rAOM. |
| Databáze: | OpenAIRE |
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