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The value of nasopharyngeal culture in predicting the etiology of acute otitis media in children less than two years of age.
Pediatr Infect Dis J. 2006 Nov; 25(11):1032-6.PI

Abstract

BACKGROUND

In selecting treatment of acute otitis media (AOM), knowledge of its etiology would be valuable. We revisited the possibility to use the nasopharyngeal culture of Streptococcus pneumoniae (Pnc) and Haemophilus influenzae (Hi) for predicting their presence in the middle ear fluid (MEF) during AOM.

METHODS

The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of bacterial culture of the nasopharyngeal aspirate (NPA) in predicting the presence of the same pathogen in the MEF were assessed during AOM events among children followed from 2 to 24 months of age.

RESULTS

The data comprised 586 AOM events. For Pnc, the sensitivity and NPV were high, 99% (95% confidence interval = 95-100%) and >99% (97-100%), respectively. The specificity and PPV were relatively low, 63% (57-68%) and 50% (43-56%). For Hi, the sensitivity and the NPV were lower (77%, 69-83% and 93%, 90-95%) than for Pnc, but the specificity and the PPV were higher (88%, 85-91% and 64%, 56-71%). The quantity of Pnc and Hi in the NPA was clearly related to their presence in the MEF. If both Pnc and Hi were found in the nasopharynx, Hi was more likely cultured from MEF.

CONCLUSION

Together with clinical and epidemiologic features of AOM, the nasopharyngeal culture can be helpful in selecting specific antimicrobial therapy.

Authors+Show Affiliations

Department of Vaccines, National Public Health Institute, Helsinki, Finland. ritva.syrjanen@ktl.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17072126

Citation

Syrjänen, Ritva K., et al. "The Value of Nasopharyngeal Culture in Predicting the Etiology of Acute Otitis Media in Children Less Than Two Years of Age." The Pediatric Infectious Disease Journal, vol. 25, no. 11, 2006, pp. 1032-6.
Syrjänen RK, Herva EE, Mäkelä PH, et al. The value of nasopharyngeal culture in predicting the etiology of acute otitis media in children less than two years of age. Pediatr Infect Dis J. 2006;25(11):1032-6.
Syrjänen, R. K., Herva, E. E., Mäkelä, P. H., Puhakka, H. J., Auranen, K. J., Takala, A. K., & Kilpi, T. M. (2006). The value of nasopharyngeal culture in predicting the etiology of acute otitis media in children less than two years of age. The Pediatric Infectious Disease Journal, 25(11), 1032-6.
Syrjänen RK, et al. The Value of Nasopharyngeal Culture in Predicting the Etiology of Acute Otitis Media in Children Less Than Two Years of Age. Pediatr Infect Dis J. 2006;25(11):1032-6. PubMed PMID: 17072126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The value of nasopharyngeal culture in predicting the etiology of acute otitis media in children less than two years of age. AU - Syrjänen,Ritva K, AU - Herva,Elja E, AU - Mäkelä,P Helena, AU - Puhakka,Heikki J, AU - Auranen,Kari J, AU - Takala,Aino K, AU - Kilpi,Terhi M, PY - 2006/10/31/pubmed PY - 2006/12/22/medline PY - 2006/10/31/entrez SP - 1032 EP - 6 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 25 IS - 11 N2 - BACKGROUND: In selecting treatment of acute otitis media (AOM), knowledge of its etiology would be valuable. We revisited the possibility to use the nasopharyngeal culture of Streptococcus pneumoniae (Pnc) and Haemophilus influenzae (Hi) for predicting their presence in the middle ear fluid (MEF) during AOM. METHODS: The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of bacterial culture of the nasopharyngeal aspirate (NPA) in predicting the presence of the same pathogen in the MEF were assessed during AOM events among children followed from 2 to 24 months of age. RESULTS: The data comprised 586 AOM events. For Pnc, the sensitivity and NPV were high, 99% (95% confidence interval = 95-100%) and >99% (97-100%), respectively. The specificity and PPV were relatively low, 63% (57-68%) and 50% (43-56%). For Hi, the sensitivity and the NPV were lower (77%, 69-83% and 93%, 90-95%) than for Pnc, but the specificity and the PPV were higher (88%, 85-91% and 64%, 56-71%). The quantity of Pnc and Hi in the NPA was clearly related to their presence in the MEF. If both Pnc and Hi were found in the nasopharynx, Hi was more likely cultured from MEF. CONCLUSION: Together with clinical and epidemiologic features of AOM, the nasopharyngeal culture can be helpful in selecting specific antimicrobial therapy. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/17072126/The_value_of_nasopharyngeal_culture_in_predicting_the_etiology_of_acute_otitis_media_in_children_less_than_two_years_of_age_ L2 - http://dx.doi.org/10.1097/01.inf.0000241097.37428.1d DB - PRIME DP - Unbound Medicine ER -