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Acute Otitis Media and Other Complications of Viral Respiratory Infection.
Pediatrics. 2016 Apr; 137(4)Ped

Abstract

BACKGROUND

Viral upper and lower respiratory tract infections (URI, LRI) are common in infants. We determined the prevalence of viral URI and its complications, including acute otitis media (AOM) and LRI, and assessed the effect of bacterial-viral interactions, and genetic and environmental risks on AOM development.

METHODS

Healthy infants were enrolled from near birth and followed to the first episode of AOM up to 12 months of age. Nasopharyngeal specimens were collected at monthly intervals (months 1-6, 9) and during viral URI episodes for bacterial culture and viral polymerase chain reaction studies. Subjects were followed closely for AOM development.

RESULTS

A total of 367 infants were followed for 286 child-years; 887 URI (305 infants) and 180 AOM episodes (143 infants) were documented. Prevalence of URI, LRI, and AOM in the first year was 3.2, 0.25, and 0.67 per child-year, respectively. Cumulative AOM incidence by ages 3, 6, and 12 months was 6%, 23%, and 46%. Infants with and without AOM had 4.7 and 2.3 URI episodes per child-year, respectively (P < .002). Pathogenic bacterial colonization rates by month were significantly higher in infants with AOM (P < .005). Breastfeeding reduced both URI and AOM risks (P < .05). Significant bacterial-viral interactions occurred with Moraxella catarrhalis and a variety of respiratory viruses and altered URI and AOM risks.

CONCLUSIONS

Almost half of infants experienced AOM by age 1. Important AOM risk factors included frequent viral URI, pathogenic bacterial colonization, and lack of breastfeeding. Bacterial-viral interactions may play a significant role in AOM pathogenesis and deserve further investigation.

Authors+Show Affiliations

Departments of Pediatrics, Pathology, tchonmai@utmb.edu.Departments of Pediatrics.Preventive Medicine and Community Health, and.Departments of Pediatrics.Departments of Pediatrics.Pathology.Departments of Pediatrics.Departments of Pediatrics.Departments of Pediatrics, Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas.Departments of Pediatrics.Departments of Pediatrics.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27020793

Citation

Chonmaitree, Tasnee, et al. "Acute Otitis Media and Other Complications of Viral Respiratory Infection." Pediatrics, vol. 137, no. 4, 2016.
Chonmaitree T, Trujillo R, Jennings K, et al. Acute Otitis Media and Other Complications of Viral Respiratory Infection. Pediatrics. 2016;137(4).
Chonmaitree, T., Trujillo, R., Jennings, K., Alvarez-Fernandez, P., Patel, J. A., Loeffelholz, M. J., Nokso-Koivisto, J., Matalon, R., Pyles, R. B., Miller, A. L., & McCormick, D. P. (2016). Acute Otitis Media and Other Complications of Viral Respiratory Infection. Pediatrics, 137(4). https://doi.org/10.1542/peds.2015-3555
Chonmaitree T, et al. Acute Otitis Media and Other Complications of Viral Respiratory Infection. Pediatrics. 2016;137(4) PubMed PMID: 27020793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute Otitis Media and Other Complications of Viral Respiratory Infection. AU - Chonmaitree,Tasnee, AU - Trujillo,Rocio, AU - Jennings,Kristofer, AU - Alvarez-Fernandez,Pedro, AU - Patel,Janak A, AU - Loeffelholz,Michael J, AU - Nokso-Koivisto,Johanna, AU - Matalon,Reuben, AU - Pyles,Richard B, AU - Miller,Aaron L, AU - McCormick,David P, Y1 - 2016/03/28/ PY - 2016/01/22/accepted PY - 2016/3/30/entrez PY - 2016/3/30/pubmed PY - 2019/3/21/medline JF - Pediatrics JO - Pediatrics VL - 137 IS - 4 N2 - BACKGROUND: Viral upper and lower respiratory tract infections (URI, LRI) are common in infants. We determined the prevalence of viral URI and its complications, including acute otitis media (AOM) and LRI, and assessed the effect of bacterial-viral interactions, and genetic and environmental risks on AOM development. METHODS: Healthy infants were enrolled from near birth and followed to the first episode of AOM up to 12 months of age. Nasopharyngeal specimens were collected at monthly intervals (months 1-6, 9) and during viral URI episodes for bacterial culture and viral polymerase chain reaction studies. Subjects were followed closely for AOM development. RESULTS: A total of 367 infants were followed for 286 child-years; 887 URI (305 infants) and 180 AOM episodes (143 infants) were documented. Prevalence of URI, LRI, and AOM in the first year was 3.2, 0.25, and 0.67 per child-year, respectively. Cumulative AOM incidence by ages 3, 6, and 12 months was 6%, 23%, and 46%. Infants with and without AOM had 4.7 and 2.3 URI episodes per child-year, respectively (P < .002). Pathogenic bacterial colonization rates by month were significantly higher in infants with AOM (P < .005). Breastfeeding reduced both URI and AOM risks (P < .05). Significant bacterial-viral interactions occurred with Moraxella catarrhalis and a variety of respiratory viruses and altered URI and AOM risks. CONCLUSIONS: Almost half of infants experienced AOM by age 1. Important AOM risk factors included frequent viral URI, pathogenic bacterial colonization, and lack of breastfeeding. Bacterial-viral interactions may play a significant role in AOM pathogenesis and deserve further investigation. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/27020793/Acute_Otitis_Media_and_Other_Complications_of_Viral_Respiratory_Infection_ DB - PRIME DP - Unbound Medicine ER -