Pitkäranta A, Jero J, Arruda E, Virolainen A, Hayden F G
University of Virginia, Health Sciences Center, Charlottesville 22908, USA.
J Pediatr. 1998 Sep;133(3):390-4. doi: 10.1016/s0022-3476(98)70276-8.
To study the association of human rhinovirus (HRV), respiratory syncytial virus (RSV), and human coronavirus infections in children aged 6 months to 12 years with otitis media with effusion (OME). To determine how long HRV RNA can be detected after HRV infection.
Middle ear effusion (MEE) samples collected at the time of tympanostomy tube placement from 100 children with OME were examined. Viral RNA was detected by reverse-transcriptase polymerase chain reaction. For HRV the results were compared with virus isolation in cell culture. In vitro studies of the persistence of HRV infectivity and RNA were conducted by combining approximately 10(5) median cell culture infectious doses of HRV with pooled MEE at 37 degrees C and assaying serial samples for 12 weeks.
Virus RNA was detected in 30 children. HRV was detected by reverse-transcriptase polymerase chain reaction in 19 children with OME and by virus isolation in 5 children. RSV RNA was found in 8 and HCV in 3 children with OME. No dual viral infection was found. Bacterial pathogens were isolated from 35 MEE samples and were associated with viral RNA in 11 cases, most often with HRV (9 cases). Under in vitro conditions, HRV culture positivity declined rapidly (<2 days), but RNA was detectable for up to 8 weeks.
These results suggest that virus infection, particularly HRV infection, either alone or concurrent with bacteria, is present in a larger percentage of children with OME than previously suspected. It remains to be determined how often the presence of viral RNA in MEE represents persistent RNA, ongoing viral replication, or recurrent infection.
研究6个月至12岁儿童感染人鼻病毒（HRV）、呼吸道合胞病毒（RSV）和人冠状病毒与中耳积液性中耳炎（OME）之间的关联。确定HRV感染后可检测到HRV RNA的时长。
对100例OME患儿在鼓膜置管时采集的中耳积液（MEE）样本进行检测。通过逆转录聚合酶链反应检测病毒RNA。对于HRV，将结果与细胞培养中的病毒分离结果进行比较。通过将约10⁵个HRV的细胞培养感染剂量中位数与合并的MEE在37℃下混合，并对连续样本进行12周检测，对HRV感染性和RNA的持续性进行体外研究。
在30名儿童中检测到病毒RNA。通过逆转录聚合酶链反应在19例OME患儿中检测到HRV，通过病毒分离在5例患儿中检测到HRV。在8例OME患儿中发现了RSV RNA，在3例患儿中发现了HCV RNA。未发现双重病毒感染。从35份MEE样本中分离出细菌病原体，其中11例与病毒RNA相关，最常见的是与HRV相关（9例）。在体外条件下，HRV培养阳性率迅速下降（<2天），但RNA可检测长达8周。
这些结果表明，病毒感染，尤其是HRV感染，单独或与细菌同时存在于OME患儿中的比例比之前怀疑的要高。MEE中病毒RNA的存在在多大程度上代表持续性RNA、正在进行的病毒复制或反复感染仍有待确定。
