Hashigucci K, Ogawa H, Kazuyama Y
E.N.T. Clinic, Kitasato Institute Hospital, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 1992 Nov;95(11):1765-72. doi: 10.3950/jibiinkoka.95.1765.
There are conflicting views concerning middle ear infections due to Chlamydia trachomatis. To ascertain the etiological role of this agent in otitis media with effusion, middle ear effusions were cultured for C. trachomatis and other bacterial flora. A total of 102 patients with otitis media with effusion (OME) were recruited for this study. The study population included 66 patients with acute OME (AOME) and 36 patients with chronic OME (COME). As Chlamydia pneumoniae, the third species of Chlamydia, is also known to be isolated from middle ear effusion of OME, the fluorescent-antibody technique using anti-C. pneumoniae or anti-C. trachomatis antibodies was employed in order to identify the inclusion bodies isolated on HeLa 229 cells as C. trachomatis. C. trachomatis was recovered from 7 patients (10.6%) with AOME and from 8 (22.2%) patients with COME. Bacteria were cultured from 20 of 63 patients with AOME and from 13 of 28 patients with COME. Pathological bacteria were cultured from only 2 patients with C. trachomatis infection in the middle ear. Only normal skin flora, no bacterial pathogens, were isolated from the remainder. Antibodies to C. trachomatis in serum were measured by a microimmunofluorescent method in 13 patients with C. trachomatis infection in the middle ear. Antichlamydial antibody of the IgG type was detected in 84.6% (11/13) of these patients. These results suggest that C. trachomatis causes middle ear infections and plays an etiological role in the pathogenesis of otitis media with effusion.
关于沙眼衣原体引起的中耳感染，存在相互矛盾的观点。为了确定该病原体在渗出性中耳炎中的病因学作用，对中耳积液进行了沙眼衣原体和其他细菌菌群的培养。本研究共招募了102例渗出性中耳炎（OME）患者。研究人群包括66例急性OME（AOME）患者和36例慢性OME（COME）患者。由于肺炎衣原体（衣原体的第三种）也已知可从OME的中耳积液中分离出来，因此采用使用抗肺炎衣原体或抗沙眼衣原体抗体的荧光抗体技术，以将在HeLa 229细胞上分离的包涵体鉴定为沙眼衣原体。在7例（10.6%）AOME患者和8例（22.2%）COME患者中分离出沙眼衣原体。在63例AOME患者中的20例和28例COME患者中的13例中培养出细菌。中耳沙眼衣原体感染的患者中只有2例培养出病原菌。其余患者仅分离出正常皮肤菌群，无细菌病原体。采用微量免疫荧光法对13例中耳沙眼衣原体感染患者血清中的沙眼衣原体抗体进行检测。这些患者中84.6%（11/13）检测到IgG型抗衣原体抗体。这些结果表明，沙眼衣原体可引起中耳感染，并在渗出性中耳炎的发病机制中起病因学作用。
