Abstract:
Abstract The present study was performed to elucidate the
clinical outcome, and etiology of acute otitis media (AOM)
in children based on virologic and bacteriologic tests. The
study group consisted of 120 children aged 6 to 144 months
with AOM. Middle ear fluid (MEF) was tested for viral
pathogens by reverse transcriptase polymerase chain reaction
(RT-PCR) and for bacteria by gram-staining and
culture. Clinical response was assessed on day 2 to 4, 11
to 13, 26 to 28. Respiratory viruses were isolated in 39
patients (32.5%). Respiratory syncytial virus (RSV)
(46.5%) was the most common virus identified in MEF
samples, followed by human rhinovirus (HRV) (25.6%),
human coronavirus (HCV) (11.6%), influenza (IV) type A
(9.3%), adenovirus type sub type A (AV) (4%), and
parainfluenza (PIV) type -3 (2%) by RT-PCR. In total 69
bacterial species were isolated from 65 (54.8%) of 120
patients. Streptococcus pneumoniae (S. pneumoniae) was
the most frequently isolated bacteria. Viral RNA was
detected in 31 (56.3%) of 55 bacteria-negative specimens
and in 8 (12.3%) of 65 bacteria-positive MEF samples. No
significant differences were found between children representing
viral infection alone, combined viral and bacterial
infection, bacterial infection alone, and neither viral nor
bacterial infection, regarding clinical cure, relapse and
reinfection rates. A significantly higher rate of secretory
otitis media (SOM) was observed in alone or combined
RSV infection with S. pneumonia or Haemophilus influenzae
(H. influenzae) than in other viruses infection. Conclusion.
This study provides information about etiologic agents and
diagnosis of AOM in Turkish children. The findings
highlight the importance of common respiratory viruses
and bacterial pathogens, particularly RSV, HRV, S. pneumoniae
and H. influenzae, in predisposing to and causing AOM
in children.
