Detection of rhinovirus, respiratory syncytial virus, and coronavirus infections in acute otitis media by reverse transcriptase polymerase chain reaction.
OBJECTIVE
To determine the frequencies of human rhinovirus (HRV), respiratory syncytial virus (RSV), and coronavirus (HCV) infection in children with acute otitis media (AOM).


METHODS
Middle ear fluids (MEF) collected by tympanocentesis and nasopharyngeal aspirates (NPA) at the time of the AOM diagnosis were examined by reverse transcriptase polymerase chain reaction for HRV, RSV, and HCV RNA.


METHODS
Ninety-two children aged 3 months to 7 years during a 1-year period.


RESULTS
Virus RNA was detected in a total of 69 children (75%) and in 44 MEF samples (48%) and 57 NPA samples (62%) at the time of AOM diagnosis. HRV RNA was detected in both MEF and NPA in 18 (20%), in MEF alone in 4 (4%), and in NPA alone in 10 (11%). RSV was detected in both MEF and NPA in 12 (13%), in MEF alone in 5 (5%), and in NPA alone in 9 (10%). HCV RNA was detected in both MEF and NPA in 5 (5%), in MEF alone in 2 (2%), and in NPA alone in 9 (10%). Dual viral infections were detected in 5% of children. HRV and RSV were detected simultaneously in 2 MEF samples and in 2 NPA samples; RSV and HCV were detected in 1 NPA sample. Bacterial pathogens were detected in 56 (62%) MEF from 91 children. Viral RNA was detected in 20 (57%) MEF of 35 bacteria-negative and in 25 (45%) of 56 bacteria-positive MEF samples. No important differences in the risk of treatment failure, relapse, or occurrence of late secretory otitis media were noted between children with virus-positive and virus-negative MEF aspirates.


CONCLUSIONS
These findings highlight the importance of common respiratory viruses, particularly HRV and RSV, in predisposing to and causing AOM in young children.
Department of Medicine, University of Virginia, Health Sciences Center, Charlottesville, Virginia 22908, USA.
A
A
Pitkäranta
A
A
Virolainen
J
J
Jero
E
E
Arruda
F G
FG
Hayden
D000208:Acute Disease; D001424:Bacterial Infections / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003139:Common Cold / Q000175:diagnosis* / Q000821:virology; D003333:Coronaviridae Infections / Q000175:diagnosis* / Q000821:virology; D017934:Coronavirus / Q000235:genetics*; D003937:Diagnosis, Differential; D004432:Ear, Middle / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000821:virology; D010033:Otitis Media / Q000175:diagnosis* / Q000821:virology; D010850:Picornaviridae Infections / Q000175:diagnosis* / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods*; D012367:RNA, Viral / Q000235:genetics; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics*; D012229:Rhinovirus / Q000235:genetics*; D017211:Treatment Failure
D012367:RNA, Viral