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Published on: April 28, 2014
Nasopharyngeal bacteriology and secretory otitis media in young children
C H Sørensen1, L P Andersen, M Tos
1Department of Otorhinolaryngology, Gentofte University Hospital, Denmark.
Insights
Streptococcus pneumoniae was more prevalent in children with secretory otitis media (SOM). This finding suggests pneumococci play a key role in the development of SOM and tubal dysfunction.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Secretory otitis media (SOM) is a common condition in young children.
- The nasopharyngeal bacteriology associated with SOM requires further investigation.
Purpose of the Study:
- To determine the prevalence of Streptococcus pneumoniae and Haemophilus influenzae in the nasopharynx of young children with and without a history of SOM.
- To explore the potential role of these bacteria in the pathogenesis of SOM.
Main Methods:
- A prevalence study involving 112 children aged 4-6 years.
- Nasopharyngeal swab samples collected from behind the soft palate.
- Bacteriological analysis to identify Streptococcus pneumoniae and Haemophilus influenzae.
- Comparison of bacterial isolation rates between children with current/previous SOM and healthy controls.
Main Results:
- Streptococcus pneumoniae isolation was significantly higher in children with SOM compared to controls (p < 0.006).
- Commonly isolated pneumococcal types (6, 19, 23) are implicated in acute otitis media.
- Haemophilus influenzae was isolated in 50% of children, with even distribution across groups.
- Specific biotypes (I-IV) accounted for 75% of H. influenzae isolates.
Conclusions:
- S. pneumoniae appears to play a significant role in the pathogenesis of tubal dysfunction and SOM.
- Quantitative differences in nasopharyngeal pneumococcal colonization may explain variations in SOM development.
Abstract:
A prevalence study was performed on the nasopharyngeal bacteriology of 112 young children, aged 4-6 years. During the preceding 2 years, 74 of these children had suffered from secretory otitis media (SOM) and 40 had had normal middle ear ventilation. At the examination, one-third of the children with SOM had improved their middle ear status (previous SOM group), whereas otomicroscopy and tympanometry remained unchanged in the healthy group. The nasopharyngeal swab sample was obtained from behind the soft palate by the oral route. The isolation rate of Streptococcus pneumoniae was significantly higher in the SOM group than in the two other groups of children (p less than 0.006). The most commonly isolated capsular types of pneumococci were 6, 19, and 23, corresponding to the types involved in acute otitis media. The isolation rate of Haemophilus influenzae was 50% and an even distribution was found among the three groups of children examined. Biotypes I, II, III and IV accounted for 75% of the isolated cases of H. influenzae. As in acute otitis media, S. pneumoniae also seemed to play an important role in the pathogenesis of tubal dysfunction and SOM, and the difference is probably caused by variations in the quantitative colonization of pneumococci in the nasopharynx.
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