The pathogens profile in children with otitis media with effusion and adenoid hypertrophy

Abstract

ObjectivesTo evaluate the presence of viruses and bacteria in middle ear and adenoids of patients with and without otitis media with effusion (OME).MethodsAdenoid samples and middle ear washes (MEW) were obtained from children with OME associated with adenoid hypertrophy undergoing adenoidectomy and tympanostomy, and compared to those obtained from patients undergoing cochlear implant surgery, as a control group. Specific DNA or RNA of 9 respiratory viruses (rhinovirus, influenza virus, picornavirus, syncytial respiratory virus, metapneumovirus, coronavirus, enterovirus, adenovirus and bocavirus) and 5 bacteria (S. pneumoniae, H. influenzae, M. catarrhalis, P. aeruginosa and S. aureus) were extracted and quantified by real-time PCR.Results37 OME and 14 cochlear implant children were included in the study. At the adenoid, virus and bacteria were similarly detected in both OME and control patients. At the middle ear washes, however, a higher prevalence of bacteria was observed in patients with OME (p = 0.01). S. pneumoniae (p = 0.01) and M. catarrhalis (p = 0.022) were the bacteria responsible for this difference. Although total virus detection was not statistically different from controls at the middle ear washes (p = 0.065), adenovirus was detected in higher proportions in adenoid samples of OME patients than controls (p = 0.019).ConclusionsDespite both OME and control patients presented similar rates of viruses and bacteria at the adenoid, children with OME presented higher prevalence of S. pneumonia, M. catarrhalis in middle ear and adenovirus in adenoids when compared to controls. These findings could suggest that these pathogens could contribute to the fluid persistence in the middle ear.

Clinical evidence based review and recommendations of aerosol generating medical procedures in otolaryngology – head and neck surgery during the COVID-19 pandemic

“…The aerosolized bone dust and irrigation fluid produced during drilling of the mastoid bone can become a potential risk for transmission of disease. Various viruses, including coronaviruses, have been documented in the middle ear mucosa during active infections [47,48]. There was significant heterogeneity among the three studies and only one study was deemed clinically relevant and of adequate quality [49].…”

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

“…A recent study profiling the different pathogens colonizing the adenoids and middle ear, nine respiratory viruses (rhinovirus, influenza virus, picornavirus, syncytial respiratory virus, metapneumovirus, coronavirus, enterovirus, adenovirus, and bocavirus) and five bacteria (S. pneumoniae, H. influenzae, M. catarrhalis, P. aeruginosa, and S. aureus) were identified [78]. When children with OME were compared to controls, it was found that adenovirus was found in significantly higher rates of patients with OME than controls.…”

Impact of COVID-19 Pandemic and Pattern of Patient Care in Otorhinolaryngology Practice in a Tertiary Referral Centre

“…Some studies evaluated the risk of aerosol contamination during the management of epistaxis by examining blood contamination of the physician's protective equipment [29][30][31].All these studies showed that the management of epistaxis causes blood aerosol transmission to the treating physician who is in close proximity to the patient.These studies also evaluated that the aerosol spread was signi cantly reduced if the patient wore a surgical mouth-mask during nasal packing [29,30] [33,34].Mastoidand middle ear surgeries should be considered as a droplet-forming procedure and an AGMP.Adequate PPE and N95 mask should be used for conducting these…”