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南印度急性中耳炎患儿中耳病原体的鼻咽部定植——一项病例对照试点研究。

Nasopharyngeal colonization of otopathogens in South Indian children with acute otitis media - A case control pilot study.

作者信息

Napolean M, Rosemol V, John M, Varghese A M, Periyasamy J, Balaji V, Naina P

机构信息

Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India.

Department of Clinical Microbiology, Christian Medical College, Vellore, India.

出版信息

J Otol. 2021 Oct;16(4):220-224. doi: 10.1016/j.joto.2021.02.004. Epub 2021 Mar 4.

Abstract

BACKGROUND

Acute otitis media (AOM) is an inflammatory disease of the middle ear causing significant morbidity in early childhood. A pilot study was undertaken to identify the role of various risk factors South Indian children with AOM, especially the role of nasopharyngeal otopathogens.

METHODOLOGY

A prospective case control pilot study was conducted in children aged below six years, presenting to a single tertiary care from 2018 to 2019. Fifty cases with AOM and 45 age and gender matched controls were recruited. Two nasopharyngeal swabs were collected, one was processed for bacterial culture. The other swab was processed according to the CDC recommended broth enrichment method to identify carriage of Subsequent serotyping was done by Quellung method and conventional sequential multiplex PCR.

RESULT

Otalgia was the major presentation seen in 92% of the children with AOM. None of the clinical and demographic characteristics were found to be statistically significant between the cases and controls. The most common otopathogen was (55%) followed by (29%). The common serotypes encountered were 11A and 19F.Nasopharyngeal colonization with [OR 6.57, p < 0.003] and [OR14.18, p < 0.003] were significant risk factors for AOM in children. The risk increased with co-colonization (OR 13.89,p < 0.003).

CONCLUSION

This study strengthens the significant association between nasopharyngeal colonization of otopathogens and AOM as a risk factor that is enhanced by co-colonization. was the main otopathogen in this population, serotypes 11A and 19F being the most common.

摘要

背景

急性中耳炎(AOM)是一种中耳炎症性疾病,在幼儿期会导致严重发病。开展了一项试点研究,以确定各种风险因素在南印度AOM儿童中的作用,尤其是鼻咽部耳病原体的作用。

方法

对2018年至2019年到一家三级医疗机构就诊的6岁以下儿童进行了一项前瞻性病例对照试点研究。招募了50例AOM患儿和45例年龄及性别匹配的对照。采集两份鼻咽拭子,一份用于细菌培养。另一份拭子按照美国疾病控制与预防中心(CDC)推荐的肉汤富集法进行处理,以鉴定携带情况。随后通过荚膜肿胀试验和传统的序列多重聚合酶链反应(PCR)进行血清分型。

结果

耳痛是92%的AOM患儿的主要表现。病例组和对照组之间的临床和人口统计学特征均无统计学意义。最常见的耳病原体是[具体病原体1](55%),其次是[具体病原体2](29%)。常见的[具体病原体1]血清型为11A和19F。鼻咽部定植[具体病原体1] [比值比(OR)6.57,p < 0.003]和[具体病原体2] [OR 为14.18,p < 0.003]是儿童AOM的重要风险因素。合并定植时风险增加(OR 13.89,p < 0.003)。

结论

本研究强化了耳病原体的鼻咽部定植与AOM之间的显著关联,且合并定植会增加这种风险因素。[具体病原体1]是该人群中的主要耳病原体,11A和19F血清型最为常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5135/8438633/2d83a825c955/gr1.jpg

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