title: The pathogens profile in children with otitis media with effusion and adenoid hypertrophy.
abstract: OBJECTIVE
  To evaluate the presence of viruses and bacteria in middle ear and adenoids of patients with and without otitis media with effusion (OME).
  
  
  METHODS
  Adenoid samples and middle ear washes (MEW) were obtained from children with OME associated with adenoid hypertrophy undergoing adenoidectomy and tympanostomy, and compared to those obtained from patients undergoing cochlear implant surgery, as a control group. Specific DNA or RNA of 9 respiratory viruses (rhinovirus, influenza virus, picornavirus, syncytial respiratory virus, metapneumovirus, coronavirus, enterovirus, adenovirus and bocavirus) and 5 bacteria (S. pneumoniae, H. influenzae, M. catarrhalis, P. aeruginosa and S. aureus) were extracted and quantified by real-time PCR.
  
  
  RESULTS
  37 OME and 14 cochlear implant children were included in the study. At the adenoid, virus and bacteria were similarly detected in both OME and control patients. At the middle ear washes, however, a higher prevalence of bacteria was observed in patients with OME (p = 0.01). S. pneumoniae (p = 0.01) and M. catarrhalis (p = 0.022) were the bacteria responsible for this difference. Although total virus detection was not statistically different from controls at the middle ear washes (p = 0.065), adenovirus was detected in higher proportions in adenoid samples of OME patients than controls (p = 0.019).
  
  
  CONCLUSIONS
  Despite both OME and control patients presented similar rates of viruses and bacteria at the adenoid, children with OME presented higher prevalence of S. pneumonia, M. catarrhalis in middle ear and adenovirus in adenoids when compared to controls. These findings could suggest that these pathogens could contribute to the fluid persistence in the middle ear.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: G P
authors.initials: GP
authors.lastname: Buzatto
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Tamashiro
authors.affiliation: Department of Genetics, Evolution, and Bioagents, Institute of Biology, University of Campinas (UNICAMP), Biology Institute, Campinas, São Paulo, Brazil.
authors.forename: J L
authors.initials: JL
authors.lastname: Proenca-Modena
authors.affiliation: Department of Molecular and Cell Biology, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: T H
authors.initials: TH
authors.lastname: Saturno
authors.affiliation: Department of Molecular and Cell Biology, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: M C
authors.initials: MC
authors.lastname: Prates
authors.affiliation: Department of Molecular and Cell Biology, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: T B
authors.initials: TB
authors.lastname: Gagliardi
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: L R
authors.initials: LR
authors.lastname: Carenzi
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: E T
authors.initials: ET
authors.lastname: Massuda
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: M A
authors.initials: MA
authors.lastname: Hyppolito
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: F C P
authors.initials: FC
authors.lastname: Valera
authors.affiliation: Department of Molecular and Cell Biology, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Arruda
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
authors.forename: W T
authors.initials: WT
authors.lastname: Anselmo-Lima
mesh_terms: D000234:Adenoids / Q000382:microbiology* / Q000473:pathology / Q000821:virology*; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D004432:Ear, Middle / Q000382:microbiology* / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D010034:Otitis Media with Effusion / Q000382:microbiology* / Q000473:pathology / Q000821:virology*; D014780:Viruses / Q000302:isolation & purification