One third of middle ear effusions from children undergoing tympanostomy tube placement had multiple bacterial pathogens 英文参考文献.docVIP

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One third of middle ear effusions from children undergoing tympanostomy tube placement had multiple bacterial pathogens 英文参考文献.doc

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One third of middle ear effusions from children undergoing tympanostomy tube placement had multiple bacterial pathogens 英文参考文献

Holderetal.BMCPediatrics2012,12:87 /1471-2431/12/87 RESEARCH OpenAccess Onethirdofmiddleeareffusionsfromchildren undergoingtympanostomytubeplacementhad multiplebacterialpathogens RobertCHolder1,DanielJKirse2,AdeleKEvans2,TimothyRPeters3,KatherineAPoehling3,4, WEdwardSwords1andSeanDReid1* Abstract Background:Becausepreviousstudieshaveindicatedthatotitismediamaybeapolymicrobialdisease,we prospectivelyanalyzedmiddleeareffusionsofchildrenundergoingtympanostomytubeplacementwithmultiplex polymerasechainreactionforfourotopathogens. Methods:Middleeareffusionsfrom207childrenundergoingroutinetympanostomytubeplacementwere collectedandwereclassifiedbythesurgeonasacuteotitismedia(AOM)forpurulenteffusionsandasotitismedia witheffusion(OME)fornon-purulenteffusions.DNAwasisolatedfromthesesamplesandanalyzedwithmultiplex polymerasechainreactionforHaemophilusinfluenzae,Streptococcuspneumoniae,Alloiococcusotitidis,andMoraxella catarrhalis. Results:119(57%)of207patientswerePCRpositiveforatleastoneofthesefourorganisms.36(30%)ofthe positivesamplesindicatedthepresenceofmorethanonebacterialspecies.Patientsampleswerefurtherseparated into2groupsbasedonclinicalpresentationatthetimeofsurgery.Sampleswerecategorizedasacuteotitismedia (AOM)ifpuswasobservedbehindthetympanicmembrane.Ifnopuswaspresent,sampleswerecategorizedas otitismediawitheffusion(OME).BacteriawereidentifiedinmostofthechildrenwithAOM(87%)andhalfthe childrenwithOME(51%,p0.001).Asinglebacterialorganismwasdetectedinmiddleeareffusionsfromchildren withAOMmoreoftenthanthosewithOME(74%versus33%,p0.001).Haemophilusinfluenzaewasthe predominantsingleorganismandcaused58%ofallAOMinthisstudy.AlloiococcusotitidisandMoraxellacatarrhalis weremorefrequentlyidentifiedinmiddleeareffusionsthanStreptococcuspneumoniae. Conclusions:Haemophilusinfluenzae,Streptococcuspneumoniae,Alloiococcusotitidis,andMoraxellacatarrhaliswere identifiedinthemiddleeareffusionsofsomepatientswithotitismedia.Overall,wefoundAOMispredominantlya singleorganisminfectionandmostco