title: Does Helicobacter pylori colonize the nasopharynx of children and contribute to their middle ear disease?
abstract: OBJECTIVE
  There is growing interest in studying the presence of HP in the upper aerodigestive tract. It was shown in several pilot studies that it colonizes the area, while other authors found no evidence of its presence there and a third group of authors believed that it had only a transient presence there. In this study we investigated a possible role for HP in middle ear disease in children.
  
  
  METHODS
  Consecutive patients undergoing myringotomy and adenoidectomy for chronic otitis media with effusion or recurrent otitis media were enrolled. Middle ear fluids were cultured on three types of agar plate (Brucella + laked horse blood; Brucella + sheep blood; and chocolate). A double polymerase chain reaction (PCR) was run to detect urease-C and adhesion subunit genes. Rapid urease enzyme testing and PCR were used on the adenoid specimens. Parents were interviewed regarding symptoms suggestive of gastroesophageal reflux in their children.
  
  
  RESULTS
  Eighteen patients were enrolled in the study (mean age 4.4 years; age range 3-8 years) with an equal gender distribution. All 28 middle ear fluid cultures were negative in all 3 media. Twenty-one of the 28 samples contained DNA, yet PCR revealed that none of them belonged to HP. Ten of the 13 adenoid specimens obtained were positive on rapid urease testing, but none on PCR. Seven of the 18 patients had at least 1 symptom suggestive of gastroesophageal reflux during the 6 months preceding the study but this did not have an impact on any of the results.
  
  
  CONCLUSIONS
  There was no evidence from this study that Helicobacter pylori (HP) colonizes the nasopharynx of children with middle ear disease, whether dyspeptic or not. There is also no apparent role for this bacterium in middle ear pathology.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, American University of Beirut Medical Center, Beirut, Lebanon. mb36@aub.edu.lb
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bitar
authors.forename: Rami
authors.initials: R
authors.lastname: Mahfouz
authors.forename: Assaad
authors.initials: A
authors.lastname: Soweid
authors.forename: Eddy
authors.initials: E
authors.lastname: Racoubian
authors.forename: Mona
authors.initials: M
authors.lastname: Ghasham
authors.forename: Ghazi
authors.initials: G
authors.lastname: Zaatari
authors.forename: Nabil
authors.initials: N
authors.lastname: Fuleihan
mesh_terms: D018829:Adhesins, Bacterial / Q000235:genetics; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D016480:Helicobacter pylori / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D010034:Otitis Media with Effusion / Q000382:microbiology*; D010865:Pilot Projects; D016133:Polymerase Chain Reaction; D012008:Recurrence; D014510:Urease / Q000235:genetics
chemical_list: D018829:Adhesins, Bacterial; D004269:DNA, Bacterial; D014510:Urease