Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand.
Centre for Longitudinal Research-He Ara ki Mua, Department of Population Health, The University of Auckland, Auckland, New Zealand.
PLoS One. 2019 Feb 22;14(2):e0212473. doi: 10.1371/journal.pone.0212473. eCollection 2019.
Chronic otitis media with effusion (COME) in children can cause prolonged hearing loss, which is associated with an increased risk of learning delays and behavioural problems. Dispersal of bacterial pathogens from the nasal passages to the middle ear is implicated in COME. We sought to determine whether there is an association between nasal microbial composition and COME in children.
A case-control study of children aged 3 and 4 years was conducted. Cases undergoing placement of tympanostomy tubes for COME were compared to healthy controls. Nasal swabs were collected and a questionnaire was administered. The V1-3 region of the 16S rRNA gene was amplified, and sequenced on the Illumina MiSeq.
73 children with COME had a lower Shannon diversity index than 105 healthy controls (1.62 [.80] versus 1.88 [.84], respectively; P = .046). The nasal microbiota of cases and controls differed in composition using Bray-Curtis dissimilarity (p = 0.002). Children with COME had a higher abundance of otopathogens and lower abundance of commensals including alpha haemolytic Streptococci and Lactococcus. Cluster analysis revealed 4 distinct nasal microbial profiles. Profiles that were Corynebacterium-dominated (aOR 4.18 [95%CI, 1.68-10.39], Streptococcus-dominated (aOR 3.12 [95%CI, 1.08-9.06], or Moraxella-dominated (aOR 4.70 [95%CI, 1.73-12.80] were associated with COME, compared to a more mixed microbial profile when controlling for age, ethnicity, and recent antibiotics use.
Children with COME have a less diverse nasal microbial composition with a higher abundance of pathogens, compared to healthy children who have a more mixed bacterial profile with a higher abundance of commensals. Further research is required to determine how nasal microbiota may relate to the pathogenesis or maintenance of COME, and whether modification of the nasal microbiota can prevent or treat children at risk of COME.
儿童慢性分泌性中耳炎（OME）可导致长期听力损失，这与学习迟缓及行为问题的风险增加有关。细菌病原体从鼻腔向中耳扩散与 OME 有关。我们试图确定儿童鼻部微生物组成与 OME 之间是否存在关联。
对 3 至 4 岁儿童进行病例对照研究。OME 患儿行鼓膜切开置管术，与健康对照组进行比较。采集鼻拭子并进行问卷调查。扩增 16S rRNA 基因的 V1-3 区，并在 Illumina MiSeq 上进行测序。
73 例 OME 患儿的 Shannon 多样性指数低于 105 例健康对照者（分别为 1.62 [0.80] 和 1.88 [0.84]；P=0.046）。病例组和对照组的鼻微生物组成存在差异（Bray-Curtis 不相似性，p=0.002）。OME 患儿的病原体丰度较高，共生菌丰度较低，包括α溶血性链球菌和乳球菌。聚类分析显示 4 种不同的鼻部微生物群特征。与更混合的微生物特征相比，棒状杆菌为主（aOR 4.18 [95%CI，1.68-10.39]）、链球菌为主（aOR 3.12 [95%CI，1.08-9.06]）或莫拉菌为主（aOR 4.70 [95%CI，1.73-12.80]）的鼻微生物群特征与 OME 相关，这与控制年龄、种族和近期使用抗生素后更混合的微生物特征相关。
与健康儿童相比，OME 患儿的鼻部微生物组成多样性较低，病原体丰度较高，而健康儿童的细菌组成更为混合，共生菌丰度较高。需要进一步研究以确定鼻部微生物群如何与 OME 的发病机制或维持相关，以及是否可以通过改变鼻腔微生物群来预防或治疗有 OME 风险的儿童。
