TY - JOUR
T1 - Prospective evaluation of the aetiology of acute otitis media with spontaneous tympanic membrane perforation
AU - Marchisio, P.
AU - Esposito, S.
AU - Picca, M.
AU - Baggi, E.
AU - Terranova, L.
AU - Orenti, A.
AU - Biganzoli, E.
AU - Principi, N.
AU - Gallia, P.
AU - Mazzucchi, E.
AU - Onorato, J.
AU - Russo, A.
AU - Vaccarino, A. M.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Objectives To evaluate the aetiological role of the main bacterial pathogens associated with acute otitis media (AOM) in children with AOM and spontaneous tympanic membrane perforation (STMP). Methods Between 1 May 2015 and 30 April 2016, 177 children, aged 6 months to 7 years, with AOM complicated by STMP within 12 h were prospectively enrolled. Middle ear fluid (MEF) was tested by real-time PCR for Streptococcus pneumoniae, non-typeable Haemophilus influenzae, Streptococcus pyogenes, Moraxella catarrhalis and Staphylococcus aureus. Results Among the 177 children with AOM and STMP, 92/100 (92.0%) of those with recurrent AOM and 13/77 (16.9%) without recurrent AOM had recurrent STMP (p <0.001). A single pathogen was identified in 70 (39.5%) MEF samples, whereas two, three and four bacteria were detected in 54 (30.5%), 20 (11.3%), and 7 (4.0%) cases, respectively. Non-typeable H. influenzae was the most common and was identified in 90 children (50.8%), followed by M. catarrhalis (62 cases, 35.0%) and S. pneumoniae (48 cases, 27.1%). Non-typeable H. influenzae was the most frequent pathogen in children with co-infections. Children with co-infections, including non-typeable H. influenzae, had significantly more frequent recurrent AOM (adjusted OR 6.609, 95% CI 1.243–39.096, p 0.029). Conclusions Recurrent AOM episodes appear to be associated with an increased risk of AOM with STMP. In AOM with STMP, non-typeable H. influenzae is detected at a high frequency, especially in children with recurrent STMP and often in association with other pathogens.
AB - Objectives To evaluate the aetiological role of the main bacterial pathogens associated with acute otitis media (AOM) in children with AOM and spontaneous tympanic membrane perforation (STMP). Methods Between 1 May 2015 and 30 April 2016, 177 children, aged 6 months to 7 years, with AOM complicated by STMP within 12 h were prospectively enrolled. Middle ear fluid (MEF) was tested by real-time PCR for Streptococcus pneumoniae, non-typeable Haemophilus influenzae, Streptococcus pyogenes, Moraxella catarrhalis and Staphylococcus aureus. Results Among the 177 children with AOM and STMP, 92/100 (92.0%) of those with recurrent AOM and 13/77 (16.9%) without recurrent AOM had recurrent STMP (p <0.001). A single pathogen was identified in 70 (39.5%) MEF samples, whereas two, three and four bacteria were detected in 54 (30.5%), 20 (11.3%), and 7 (4.0%) cases, respectively. Non-typeable H. influenzae was the most common and was identified in 90 children (50.8%), followed by M. catarrhalis (62 cases, 35.0%) and S. pneumoniae (48 cases, 27.1%). Non-typeable H. influenzae was the most frequent pathogen in children with co-infections. Children with co-infections, including non-typeable H. influenzae, had significantly more frequent recurrent AOM (adjusted OR 6.609, 95% CI 1.243–39.096, p 0.029). Conclusions Recurrent AOM episodes appear to be associated with an increased risk of AOM with STMP. In AOM with STMP, non-typeable H. influenzae is detected at a high frequency, especially in children with recurrent STMP and often in association with other pathogens.
KW - Acute otitis media
KW - Moraxella catarrhalis
KW - Non-typeable Haemophilus influenzae
KW - Spontaneous tympanic membrane perforation
KW - Staphylococcus aureus
KW - Streptococcus pneumoniae
KW - Streptococcus pyogenes
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U2 - 10.1016/j.cmi.2017.01.010
DO - 10.1016/j.cmi.2017.01.010
M3 - Article
AN - SCOPUS:85014638466
VL - 23
SP - 486.e1-486.e6
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
SN - 1198-743X
IS - 7
ER -