Pettigrew Melinda M, Gent Janneane F, Triche Elizabeth W, Belanger Kathleen D, Bracken Michael B, Leaderer Brian P
Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034, USA.
Paediatr Perinat Epidemiol. 2004 Nov;18(6):441-7. doi: 10.1111/j.1365-3016.2004.00596.x.
Otitis media is one of the most common infections of early childhood. Children who first experience acute otitis media at an early age (before 6 months) are at increased risk for recurrent otitis media. This prospective study investigated exposure to measured levels of airborne household mould and the risk of early otitis media in the first 6 months of life among a cohort of infants at high risk for asthma. Between September 1996 and December 1998, women were invited to participate if they had at least one other child with physician-diagnosed asthma. Mothers were given a standardised questionnaire within 4 months of their infant's birth. Airborne mould samples were also taken at this time, and culturable fungi were categorised into four levels according to the report of the Commission of European Communities: 0 (undetectable), 1-499 colony forming units (CFU)/m(3) (low), 500-999 CFU/m(3) (medium), > or =1000 CFU/m(3) (high). Infant respiratory symptoms were collected during quarterly telephone interviews at 6, 9 and 12 months of age. Of the 806 children in the study, 27.8% experienced otitis media before six months of age. Household levels of Penicillium and Cladosporium were modestly associated with the number of otitis media episodes (P = 0.056 and 0.081 respectively). After controlling for potential confounders, Penicillium and Cladosporium were not associated with early otitis media. High levels of 'other' mould (defined as total spore count minus counts for Penicillium, Cladosporium, and yeast) were associated with early otitis media (OR 3.49; 95% CI [1.38, 8.79]). We also found associations between day-care outside of the home and birth during the summer or fall season with early otitis media. This study is suggestive of a relationship between otitis media and mould that warrants further study.
中耳炎是幼儿期最常见的感染之一。在幼年（6个月前）首次经历急性中耳炎的儿童患复发性中耳炎的风险会增加。这项前瞻性研究调查了一组有哮喘高风险的婴儿在出生后头6个月接触空气中测量到的家庭霉菌水平与早期中耳炎风险之间的关系。在1996年9月至1998年12月期间，如果女性至少有一个经医生诊断患有哮喘的孩子，就邀请她们参与研究。母亲们在婴儿出生后4个月内会收到一份标准化问卷。此时还会采集空气中的霉菌样本，可培养真菌根据欧洲共同体委员会的报告分为四个级别：0（未检测到）、1 - 499菌落形成单位（CFU）/立方米（低）、500 - 999 CFU/立方米（中）、≥1000 CFU/立方米（高）。在婴儿6个月、9个月和12个月大时，通过季度电话访谈收集婴儿的呼吸道症状。在该研究的806名儿童中，27.8%在6个月前患过中耳炎。家庭中青霉素和枝孢菌的水平与中耳炎发作次数有一定关联（分别为P = 0.056和0.081）。在控制了潜在混杂因素后，青霉素和枝孢菌与早期中耳炎无关。高水平的“其他”霉菌（定义为总孢子数减去青霉素、枝孢菌和酵母的计数）与早期中耳炎相关（比值比3.49；95%置信区间[1.38, 8.79]）。我们还发现家庭外日托以及夏季或秋季出生与早期中耳炎之间存在关联。这项研究表明中耳炎与霉菌之间的关系值得进一步研究。
