Presence of viral and bacterial pathogens in the nasopharynx of otitis-prone children. A prospective study.
OBJECTIVE
The purpose of the present study was to examine and follow up the presence of respiratory viral and bacterial pathogens in the nasopharynx of otitis-prone children during the cold season and compare the findings with the child's respiratory symptoms.


METHODS
We enrolled 121 otitis-prone children, aged 10 months to 4 years for a prospective study. The nasopharyngeal swab (NPS) were studied at the baseline and after 12 and 24 weeks for respiratory viruses and at the baseline and after 24 weeks for bacteria. Presence of picorna(rhino-entero-parecho)-, influenza-, adenoviruses and Mycoplasma pneumoniae was detected by PCR. NPS specimens were cultured for Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Clinical data (the rate of respiratory symptom days, otitis media, tympanometry findings, day-care attendance and the number of siblings) were compared with microbiological data.


RESULTS
Rhinovirus was found in 30% of the samples at the baseline, in 8% and in 19% of the samples after 12 and 24 weeks, respectively. Enterovirus was detected in 19% of the samples, in 21% and in 12% of samples after 12 and 24 weeks, respectively. Picornavirus positivity correlated with the respiratory symptoms but not with the number of otitis media or with abnormal tympanometry. Two samples were adeno- and three samples influenzavirus positive. Parechovirus and M. pneumoniae were negative in all samples. Rhinovirus positivity correlated with that of M. catarrhalis and S. pneumonia but not with H. influenzae. Microbiological positivity was not significantly associated with the type of day-care.


CONCLUSIONS
Picornaviruses as well as bacteria were commonly found in the nasopharynx of otitis-prone children during the cold season, even in the absence of clinical symptoms.
Pitkäranta
Anne
A
Department of Otorhinolaryngology, Helsinki University Central Hospital, POB 220, FIN-00029 Helsinki, Finland. anne.pitkaranta@hus.fi
Roivainen
Merja
M
Blomgren
Karin
K
Peltola
Joanna
J
Kaijalainen
Tarja
T
Räty
Riitta
R
Ziegler
Thedi
T
Rönkkö
Esa
E
Hatakka
Katja
K
Korpela
Riitta
R
Poussa
Tuija
T
Leinonen
Maija
M
Hovi
Tapani
T
D001419:Bacteria / Q000302:isolation & purification*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000382:microbiology* / Q000821:virology*; D010033:Otitis Media; D011446:Prospective Studies; D014780:Viruses / Q000302:isolation & purification*