Department of Specialistic Surgical Sciences, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Otolaryngol Head Neck Surg. 2012 Jun;146(6):991-6. doi: 10.1177/0194599812438169. Epub 2012 Feb 21.
Bacterial biofilms have been detected in biopsies of the adenoid and middle ear mucosa of otitis-prone children and children with chronic middle otitis media. However, the invasiveness of biopsy makes it unsuitable for routine clinical practice, especially in pediatrics. This study aimed to investigate nasopharyngeal biofilm-producing otopathogens (BPOs) of nasopharyngeal swabs (NPS) in children with a history of nonsevere recurrent acute otitis media (RAOM) and healthy controls.
A cross-sectional study with planned data collection.
University of Milan.
Transoral NPS were taken from infants and children aged 10 months to 11 years with nonsevere RAOM or healthy controls without adenoid hypertrophy. Nasopharyngeal colonization by otopathogens was assessed by means of microbiological cultures and standard bacterial identification, as well as nasopharyngeal BPOs by means of spectrophotometric analysis.
The study involved 113 children (56.6% males; median age 40 months; range, 10-132 months): 58 with a history of nonsevere RAOM (51.3%) and 55 controls (48.7%). Otopathogens were significantly more frequently detected in the RAOM group (24/58, 41.4%) than in controls (8/55, 14.5%; P = .003); the main pathogens were respectively Haemophilus influenzae (12/24, 50.0%) and Streptococcus pyogenes (3/8, 37.5%). Nasopharyngeal BPOs were more frequently isolated in the RAOM group (17/58, 29.3%) than in controls (6/55, 10.9%; P = .02). H influenzae (12/17, 70.6%) was confirmed as the main pathogen in the RAOM group.
The presence of nasopharyngeal BPOs is an important factor favoring RAOM; it is therefore useful investigating biofilms even in children with nonsevere recurrences of AOM without adenoid hypertrophy.
已在易患中耳炎和慢性中耳乳突炎儿童的腺样体和中耳粘膜活检中检测到细菌生物膜。然而，活检的侵入性使其不适合常规临床实践，尤其是在儿科领域。本研究旨在研究有反复发作性非严重性急性中耳炎（RAOM）病史和健康对照组儿童的鼻咽拭子（NPS）中鼻咽生物膜产耳病原体（BPO）。
一项有计划数据收集的横断面研究。
米兰大学。
对 10 个月至 11 岁患有非严重性 RAOM 或无腺样体肥大的健康对照组的婴儿和儿童进行经口鼻咽拭子取样。通过微生物培养和标准细菌鉴定评估耳病原体的鼻咽定植情况，通过分光光度分析法评估鼻咽 BPO。
该研究共纳入 113 名儿童（56.6%为男性；中位年龄为 40 个月；范围为 10-132 个月）：58 名患有非严重性 RAOM（51.3%）和 55 名对照组（48.7%）。RAOM 组中，耳病原体的检出率显著高于对照组（24/58，41.4%比 8/55，14.5%；P=0.003）；主要病原体分别为流感嗜血杆菌（12/24，50.0%）和化脓性链球菌（3/8，37.5%）。RAOM 组中，鼻咽 BPO 的检出率显著高于对照组（17/58，29.3%比 6/55，10.9%；P=0.02）。流感嗜血杆菌（12/17，70.6%）被确认为 RAOM 组的主要病原体。
鼻咽部 BPO 的存在是促进 RAOM 的一个重要因素；因此，即使对无腺样体肥大的非严重性 AOM 反复发作的儿童，也可以通过调查生物膜来获益。
