Karma P, Sipilä P, Virtanen T, Luotonen J, Sipilä M, Häivä V M
Int J Pediatr Otorhinolaryngol. 1985 Nov;10(2):181-90. doi: 10.1016/s0165-5876(85)80031-8.
Fifty-four ears with evidence of pneumococcus (Pn) in the first acute otitis media (AOM) in 38 infants and with prolongation or recurrence of the MEF during the follow-up were observed for 7-22 months for the presence of Pn by culture or of pneumococcal antigen (Pn-ag) by counterimmunoelectrophoresis or latex agglutination methods in their MEFs. During the first three 1-month observation periods, Pn and/or Pn-ags were detected in 24% to 9% of these ears, always of the initial type/group. Later on new Pn types/groups appeared also. In two of the 9 MEFs persisting for greater than or equal to 3 months, initial Pn-ag, with culturable Pn, was repeatedly found but not for longer than 5 months. Of the 12 ears resulting in secretory otitis media (SOM) only one showed initial Pn-ag (and Pn) in the MEF of SOM. Pneumococcal type/group pattern associated with prolongation or recurrence of infection did not differ from that of initial AOM. In another series of 151 SOM ears in 97 children, Pn-ags were detected in 7 MEFs. Four of them grew Pn, each of the corresponding group. Our studies suggest that the persistence of Pn-ags in the middle ear after AOM is limited and their occurrence in the MEFs of SOM is rare. Thus, the role of the persistence of Pn-ags in prolonged, recurrent or secretory otitis media seems questionable.
对38例婴儿首次急性中耳炎（AOM）时有肺炎球菌（Pn）证据且随访期间中耳积液（MEF）延长或复发的54只耳朵，通过培养检测Pn或通过对流免疫电泳或乳胶凝集法检测其MEF中的肺炎球菌抗原（Pn-ag），观察7至22个月。在最初的三个1个月观察期内，这些耳朵中有24%至9%检测到Pn和/或Pn-ags，均为初始类型/组。后来也出现了新的Pn类型/组。在持续大于或等于3个月的9个MEF中的2个中，反复发现初始Pn-ag及可培养的Pn，但持续时间不超过5个月。在导致分泌性中耳炎（SOM）的12只耳朵中，只有1只在SOM的MEF中显示初始Pn-ag（和Pn）。与感染延长或复发相关的肺炎球菌类型/组模式与初始AOM无异。在另一组97例儿童的151只SOM耳朵中，7个MEF检测到Pn-ags。其中4个培养出Pn，各为相应组。我们的研究表明，AOM后中耳中Pn-ag的持续存在是有限的，且在SOM的MEF中很少出现。因此，Pn-ag持续存在在迁延性、复发性或分泌性中耳炎中的作用似乎值得怀疑。
