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Viral-bacterial co-infection in Australian Indigenous children with acute otitis media

Michael J Binks1, Allen C Cheng, Heidi Smith-Vaughan

  • 1Ear and Respiratory Unit, Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia. michael.binks@menzies.edu.au

BMC Infectious Diseases
|June 9, 2011
PubMed

Insights

Respiratory viruses, particularly adenovirus (HAdV), exacerbate bacterial ear infections in Indigenous children. Higher bacterial loads in the nasopharynx correlate with acute otitis media, increasing perforation risk.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology
  • Epidemiology

Background:

  • Acute otitis media with perforation (AOMwiP) is highly prevalent in remote Indigenous children.
  • Key bacterial pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
  • The role of antecedent viral infections in disease progression is under investigation.

Purpose of the Study:

  • To investigate the association between antecedent respiratory viral infections and bacterial load in Indigenous children.
  • To determine if viral infections increase the risk of acute otitis media (AOM) and perforation.
  • To explore the relationship between bacterial density and clinical ear status.

Main Methods:

  • Retrospective analysis of 366 nasopharyngeal swabs from 114 Indigenous children.
  • Screening for 17 respiratory viruses using PCR.
  • Quantification of bacterial densities for S. pneumoniae, H. influenzae, and M. catarrhalis using quantitative real-time PCR.

Main Results:

  • High prevalence of M. catarrhalis (96%), H. influenzae (91%), S. pneumoniae (89%), and respiratory viruses (59%).
  • Significantly higher geometric mean bacterial loads in children with AOM compared to controls.
  • Adenovirus (HAdV) infection was independently associated with a 3-fold increased likelihood of AOM (p < 0.001).

Conclusions:

  • Confirms a positive association between nasopharyngeal bacterial load and AOM in Indigenous children.
  • Respiratory viruses exacerbate bacterial ear infections.
  • Adenovirus (HAdV) is independently linked to acute ear conditions.
Abstract

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