title: Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study.
abstract: Acute otitis media is the most frequent diagnosis in children visiting physicians' offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based prospective cohort the risk factors for otitis media in the second year of life with special emphasis on the role of colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The study was embedded in the Generation R Study. Data on risk factors and doctor-diagnosed otitis media were obtained by midwives, hospital registries and postal questionnaires in the whole cohort (n = 7,295). Nasopharyngeal swabs were obtained at the age of 1.5, 6 and 14 months in the focus cohort (n = 1,079). Of these children, 2,515 (47.2%) suffered at least one period of otitis media in their second year of life. The occurrence of otitis media during the follow-up period in the first 6 months of life and between 6 and 12 months of age was associated with the risk of otitis media in the second year of life (aOR, 1.83 95% CI 1.24-2.71 and aOR 2.72, 95% CI 2.18-3.38, respectively). Having siblings was associated with an increased risk for otitis media in the second year of life (aOR 1.42, 95% CI 1.13-1.79). No associations were found between bacterial carriage in the first year of life and otitis media in the second year of life. In our study, otitis media in the first year of life is an independent risk factor for otitis media in the second year of life. Surprisingly, bacterial carriage in the first year of life did not add to this risk. Moreover, no association was observed between bacterial carriage in the first year of life and otitis in the second year of life.
authors.affiliation: The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Joost A M
authors.initials: JA
authors.lastname: Labout
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Duijts
authors.forename: Ankie
authors.initials: A
authors.lastname: Lebon
authors.forename: Ronald
authors.initials: R
authors.lastname: de Groot
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Vincent V W
authors.initials: VV
authors.lastname: Jaddoe
authors.forename: Henri A
authors.initials: HA
authors.lastname: Verbrugh
authors.forename: Peter W M
authors.initials: PW
authors.lastname: Hermans
authors.forename: Henriëtte A
authors.initials: HA
authors.lastname: Moll
mesh_terms: D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D009305:Nasopharynx / Q000382:microbiology; D009426:Netherlands / Q000453:epidemiology; D010033:Otitis Media / Q000453:epidemiology / Q000382:microbiology*; D011446:Prospective Studies; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
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