The role of chronic infection in children with otitis media with effusion: Evidence for intracellular persistence of bacteria

被引:53
作者
Coates, Harvey [1 ]
Thornton, Ruth [1 ]
Langlands, Jennifer [1 ]
Filion, Pierre
Keil, Anthony D.
Vijayasekaran, Shyan
Richmond, Peter [1 ]
机构
[1] Univ Western Australia, Sch Paediat & Child Hlth, Nedlands, WA 6009, Australia
关键词
D O I
10.1016/j.otohns.2007.02.009
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
OBJECTIVE: Demonstrate mucosal bacterial infection in children with otitis media with effusion (OME). STUDY DESIGN AND SETTING: Middle ear mucosal biopsies from 11 children with OME were examined for bacteria utilizing transmission electron microscopy. This was correlated with standard culture and polymerase chain reaction (PCR) of middle ear effusions. RESULTS: Gram-positive coccal bacteria were demonstrated in middle ear mucosal epithelial cells of 4 of 11 (36%) children. Morphological appearance of bacteria and detection of pneumolysin DNA by PCR in middle ear fluid suggests a role for persistent intracellular infection with Streptococcus pneumoniae and other gram-positive cocci in some cases of OME. CONCLUSION: Intracellular bacterial infection of middle ear mucosal epithelial cells in children with OME may be an important mechanism for bacterial persistence, and contribute to inflammation and mucus production in the pathogenesis of this condition. SIGNIFICANCE: Persistent intracellular infection is a novel paradigm for OME pathogenesis in children and may influence antibiotic effectiveness in treatment of this condition. (C) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
引用
收藏
页码:778 / 781
页数:4
相关论文
共 19 条
[1]   10-YEAR REVIEW OF OTITIS-MEDIA PATHOGENS [J].
BLUESTONE, CD ;
STEPHENSON, JS ;
MARTIN, LM .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 1992, 11 (08) :S7-S11
[2]  
Coates H, 2004, ADV THER, P299
[3]  
Costerton W, 2003, J CLIN INVEST, V112, P1466, DOI 10.1172/JCI200320365
[4]   Is otitis media with effusion a biofilm infection? [J].
Fergie, N ;
Bayston, R ;
Pearson, JP ;
Birchall, JP .
CLINICAL OTOLARYNGOLOGY, 2004, 29 (01) :38-46
[5]  
Freid V M, 1998, Vital Health Stat 13, P1
[6]   Direct detection of bacterial Biofilms on the middle-ear mucosa of children with chronic otitis media [J].
Hall-Stoodley, Luanne ;
Hu, Fen Ze ;
Gieseke, Armin ;
Nistico, Laura ;
Nguyen, Duc ;
Hayes, Jay ;
Forbes, Michael ;
Greenberg, David P. ;
Dice, Bethany ;
Burrows, Amy ;
Wackym, P. Ashley ;
Stoodley, Paul ;
Post, J. Christopher ;
Ehrlich, Garth D. ;
Kerschner, Joseph E. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 296 (02) :202-211
[7]   High incidence of Alloiococcus otitis in otitis media with effusion [J].
Hendolin, PH ;
Kärkkäinen, U ;
Himi, T ;
Markkanen, A ;
Ylikoski, J .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 1999, 18 (10) :860-865
[8]   Use of green fluorescent protein in visualisation of pneumococcal invasion of broncho-epithelial cells in vivo [J].
Kadioglu, A ;
Sharpe, JA ;
Lazou, I ;
Svanborg, C ;
Ockleford, C ;
Mitchell, TJ ;
Andrew, PW .
FEMS MICROBIOLOGY LETTERS, 2001, 194 (01) :105-110
[9]   Activities of antimicrobial agents against intracellular pneumococci [J].
Mandell, GL ;
Coleman, EJ .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2000, 44 (09) :2561-2563
[10]   The frequency of otitis media with effusion in British pre-school children: a guide for treatment [J].
Midgley, EJ ;
Dewey, C ;
Pryce, K ;
Maw, AR .
CLINICAL OTOLARYNGOLOGY, 2000, 25 (06) :485-491