Department of Pharmaceutics-Microbiology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Saudi Pharm J. 2012 Oct;20(4):345-53. doi: 10.1016/j.jsps.2012.02.004. Epub 2012 Mar 3.
Helicobacter pylori (H. pylori) are pathogenic bacteria that infect a half of the human population, colonize gastric mucosa and can be found in gastric juice. Reflux of gastric juice has been suggested to be associated with glue ear in children. It has been suggested that tonsil and adenoid tissues are potential reservoirs of H. pylori infection. These observations raise the question as to whether H. pylori infection might have a role in otitis media with effusion (OME) in children. The objectives of this research were to evaluate the incidence and possible role of H. pylori in the pathogenesis of OME in children and to evaluate the clarithromycin-resistant strains. Molecular assessment was done to evaluate the culture results vs. molecular study. A total of 60 children, who were prone to ventilation tube insertion, adenoidectomy and/or tonsillectomy were included in the study. The control group consisted of 40 children who underwent adenoidectomy and/or tonsillectomy without the history of OME. Samples of the middle ear fluid and mucosa, adenoid tissue, tonsillar tissue and gastric lavage were cultured and underwent polymerase chain reaction (PCR) analysis then were assembled by using QIAxcel System as capillary electrophoresis for H. pylori detection. There was significant difference between the results of cultures and PCR (P < 0.05). Middle ear fluid culture was positive for H. pylori in 40% of the patients vs. 56.7% PCR results while middle ear mucosa culture was positive in 20% vs. 26.7% PCR results. Gastric lavage culture was positive in 46.6% of the patients and PCR was positive in 63.3% of the patients. Adenoid culture and PCR were positive in 56.3% for each, while tonsil culture was positive in 70% and PCR was positive in 90%. H. pylori presence in the gastric lavage, the tonsillar and adenoid tissues by culture and PCR was significantly more frequent in the study group compared to the control group. The minimum inhibitory concentration (MIC) values of clarithromycin-resistant isolates ranged from 1.5 to 8 μg/ml. This study showed the presence of H. pylori in around 50% of the patients with OME. PCR revealed its sensitivity than culture techniques. The incidence of clarithromycin resistance was found to be high among the isolates (39.6%).
幽门螺杆菌（H. pylori）是一种感染一半人类的致病细菌，定植于胃黏膜并可在胃液中检出。已有研究表明胃内容物反流与儿童胶耳有关。扁桃体和腺样体组织被认为是 H. pylori 感染的潜在储库。这些观察结果提出了一个问题，即 H. pylori 感染是否可能在儿童分泌性中耳炎（OME）中起作用。本研究旨在评估 H. pylori 在儿童 OME 发病机制中的发生率和可能作用，并评估克拉霉素耐药株。通过分子评估对培养结果与分子研究进行了比较。共纳入 60 例有行鼓膜置管术、腺样体切除术和/或扁桃体切除术适应证的患儿，作为研究组。对照组由 40 例既往无 OME 病史而行腺样体切除术和/或扁桃体切除术的患儿组成。对中耳液、黏膜、腺样体、扁桃体和胃灌洗液进行培养和聚合酶链反应（PCR）分析，然后使用 QIAxcel 系统作为毛细管电泳进行 H. pylori 检测。培养与 PCR 结果有显著差异（P<0.05）。中耳液 H. pylori 培养阳性率为 40%，PCR 阳性率为 56.7%；中耳黏膜培养阳性率为 20%，PCR 阳性率为 26.7%。胃灌洗液培养 H. pylori 阳性率为 46.6%，PCR 阳性率为 63.3%。腺样体培养和 PCR 阳性率均为 56.3%，扁桃体培养和 PCR 阳性率均为 70%和 90%。研究组胃灌洗液、扁桃体和腺样体组织 H. pylori 培养和 PCR 阳性率均显著高于对照组。克拉霉素耐药分离株的最小抑菌浓度（MIC）值范围为 1.5 至 8μg/ml。本研究显示，OME 患儿中有 50%左右存在 H. pylori。PCR 比培养技术更能显示其敏感性。克拉霉素耐药株的发生率较高（39.6%）。
