Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection

Acute otitis media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute otitis media associated with specific combinations of respiratory viruses and acute otitis media bacterial pathogens. Data were fro...

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Bibliographic Details
Published in:Journal of clinical microbiology Vol. 49; no. 11; p. 3750
Main Authors: Pettigrew, Melinda M, Gent, Janneane F, Pyles, Richard B, Miller, Aaron L, Nokso-Koivisto, Johanna, Chonmaitree, Tasnee
Format: Journal Article
Language:English
Published: United States 01.11.2011
Subjects:
Child, Preschool
Cohort Studies
Comorbidity
Haemophilus influenzae - isolation & purification
Human bocavirus - isolation & purification
Humans
Infant
Metapneumovirus - isolation & purification
Microbial Interactions
Moraxella (Branhamella) catarrhalis - isolation & purification
Otitis Media - epidemiology
Otitis Media - microbiology
Otitis Media - virology
Polymerase Chain Reaction
Prospective Studies
Respiratory Syncytial Viruses - isolation & purification
Respiratory Tract Infections - complications
Respiratory Tract Infections - microbiology
Respiratory Tract Infections - virology
Risk Assessment
Streptococcus pneumoniae - isolation & purification
ISSN:1098-660X, 1098-660X
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Summary:Acute otitis media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute otitis media associated with specific combinations of respiratory viruses and acute otitis media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of acute otitis media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P < 0.05 by χ(2) test). Children with high respiratory syncytial virus loads (≥3.16 × 10(7) copies/ml) experienced increased acute otitis media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with acute otitis media. In adjusted models controlling for the presence of key viruses, bacteria, and acute otitis media risk factors, acute otitis media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute otitis media risk differs by the specific viruses and bacteria involved. Acute otitis media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to acute otitis media bacterial pathogens.
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ISSN:1098-660X
1098-660X
DOI:10.1128/JCM.01186-11