Pitkäranta A, Virolainen A, Jero J, Arruda E, Hayden F G
Department of Medicine, University of Virginia, Health Sciences Center, Charlottesville, Virginia 22908, USA.
Pediatrics. 1998 Aug;102(2 Pt 1):291-5. doi: 10.1542/peds.102.2.291.
To determine the frequencies of human rhinovirus (HRV), respiratory syncytial virus (RSV), and coronavirus (HCV) infection in children with acute otitis media (AOM).
Middle ear fluids (MEF) collected by tympanocentesis and nasopharyngeal aspirates (NPA) at the time of the AOM diagnosis were examined by reverse transcriptase polymerase chain reaction for HRV, RSV, and HCV RNA.
Ninety-two children aged 3 months to 7 years during a 1-year period.
Virus RNA was detected in a total of 69 children (75%) and in 44 MEF samples (48%) and 57 NPA samples (62%) at the time of AOM diagnosis. HRV RNA was detected in both MEF and NPA in 18 (20%), in MEF alone in 4 (4%), and in NPA alone in 10 (11%). RSV was detected in both MEF and NPA in 12 (13%), in MEF alone in 5 (5%), and in NPA alone in 9 (10%). HCV RNA was detected in both MEF and NPA in 5 (5%), in MEF alone in 2 (2%), and in NPA alone in 9 (10%). Dual viral infections were detected in 5% of children. HRV and RSV were detected simultaneously in 2 MEF samples and in 2 NPA samples; RSV and HCV were detected in 1 NPA sample. Bacterial pathogens were detected in 56 (62%) MEF from 91 children. Viral RNA was detected in 20 (57%) MEF of 35 bacteria-negative and in 25 (45%) of 56 bacteria-positive MEF samples. No important differences in the risk of treatment failure, relapse, or occurrence of late secretory otitis media were noted between children with virus-positive and virus-negative MEF aspirates.
These findings highlight the importance of common respiratory viruses, particularly HRV and RSV, in predisposing to and causing AOM in young children.
确定急性中耳炎（AOM）患儿中人鼻病毒（HRV）、呼吸道合胞病毒（RSV）和冠状病毒（HCV）的感染频率。
在AOM诊断时，通过鼓膜穿刺术收集的中耳积液（MEF）和鼻咽抽吸物（NPA），采用逆转录聚合酶链反应检测HRV、RSV和HCV RNA。
1年内92名年龄在3个月至7岁的儿童。
在AOM诊断时，共69名儿童（75%）检测到病毒RNA，44份MEF样本（48%）和57份NPA样本（62%）检测到病毒RNA。18名儿童（20%）的MEF和NPA均检测到HRV RNA，4名儿童（4%）仅MEF检测到HRV RNA，10名儿童（11%）仅NPA检测到HRV RNA。12名儿童（13%）的MEF和NPA均检测到RSV，5名儿童（5%）仅MEF检测到RSV，9名儿童（10%）仅NPA检测到RSV。5名儿童（5%）的MEF和NPA均检测到HCV RNA，2名儿童（2%）仅MEF检测到HCV RNA，9名儿童（10%）仅NPA检测到HCV RNA。5%的儿童检测到双重病毒感染。2份MEF样本和2份NPA样本同时检测到HRV和RSV；1份NPA样本检测到RSV和HCV。91名儿童的56份MEF中检测到细菌病原体。35份细菌阴性的MEF中有20份（57%）检测到病毒RNA，56份细菌阳性的MEF中有25份（45%）检测到病毒RNA。病毒阳性和病毒阴性的MEF抽吸物患儿在治疗失败、复发或迟发性分泌性中耳炎发生风险方面未发现重要差异。
这些发现凸显了常见呼吸道病毒，尤其是HRV和RSV，在幼儿易患和引发AOM中的重要性。
