Seppälä Elina M, Oikarinen Sami, Lehtonen Jussi P, Neupane Subas, Honkanen Hanna, Tyni Iiris, Siljander Heli, Ilonen Jorma, Sillanpää Saara, Laranne Jussi, Knip Mikael, Hyöty Heikki
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.
J Infect Dis. 2020 Jun 29;222(2):324-332. doi: 10.1093/infdis/jiaa087.
Human rhinoviruses (HRVs), human enteroviruses (HEVs) and human parechoviruses (HPeVs) have been linked to acute otitis media (AOM). We evaluated this association in a prospective birth cohort setting.
A total of 324 healthy infants were followed up from birth to age 3 years. Nasal swab samples were collected at age 3, 6, 12, 18, 24, and 36 months and screened for HRV and HEV using real-time reverse-transcription quantitative polymerase chain reaction. Stool samples were collected monthly and analyzed for HRV, HEV, and HPeV. AOM episodes diagnosed by physicians were reported by parents in a diary. The association of viruses with AOM was analyzed using generalized estimation equations, and their relative contributions using population-attributable risk percentages.
A clear association was found between AOM episodes and simultaneous detection of HEV (adjusted odds ratio for the detection of virus in stools, 2.04; 95% confidence interval, 1.06-3.91) and HRV (1.54; 1.04-2.30). HPeV showed a similar, yet nonsignificant trend (adjusted odds ratio, 1.44; 95% confidence interval, .81-2.56). HRV and HEV showed higher population-attributable risk percentages (25% and 20%) than HPeV (11%).
HEVs and HRVs may contribute to the development of AOM in a relatively large proportion of cases.
人鼻病毒（HRV）、人肠道病毒（HEV）和人细小病毒（HPeV）与急性中耳炎（AOM）有关。我们在一个前瞻性出生队列中评估了这种关联。
共有324名健康婴儿从出生随访至3岁。在3、6、12、18、24和36月龄时采集鼻拭子样本，使用实时逆转录定量聚合酶链反应筛查HRV和HEV。每月采集粪便样本，分析其中的HRV、HEV和HPeV。医生诊断的AOM发作由家长记录在日记中。使用广义估计方程分析病毒与AOM的关联，并使用人群归因风险百分比分析它们的相对贡献。
发现AOM发作与同时检测到HEV（粪便中检测到病毒的调整比值比为2.04；95%置信区间为1.06 - 3.91）和HRV（1.54；1.04 - 2.30）之间存在明显关联。HPeV呈现出类似但不显著的趋势（调整比值比为1.44；95%置信区间为0.81 - 2.56）。HRV和HEV的人群归因风险百分比（分别为25%和20%）高于HPeV（11%）。
在相当一部分病例中，HEV和HRV可能导致AOM的发生。
