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

Melinda M. Pettigrew, Janneane F. Gent, Richard Pyles, Aaron L. Miller, Johanna Nokso-Koivisto, Tasnee Chonmaitree

Research output: Contribution to journalArticle

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Abstract

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 7copies/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.

Original languageEnglish (US)
Pages (from-to)3750-3755
Number of pages6
JournalJournal of Clinical Microbiology
Volume49
Issue number11
DOIs
StatePublished - Nov 2011

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Otitis Media
Respiratory Tract Infections
Bocavirus
Respiratory Syncytial Viruses
Viruses
Haemophilus influenzae
Metapneumovirus
Bacteria
Odds Ratio
Confidence Intervals
Streptococcus pneumoniae
Viral Load
Adenoviridae
Human bocavirus
Moraxella (Branhamella) catarrhalis
Respiratory Syncytial Virus Infections
Logistic Models
Prospective Studies

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection. / Pettigrew, Melinda M.; Gent, Janneane F.; Pyles, Richard; Miller, Aaron L.; Nokso-Koivisto, Johanna; Chonmaitree, Tasnee.

In: Journal of Clinical Microbiology, Vol. 49, No. 11, 11.2011, p. 3750-3755.

Research output: Contribution to journalArticle

Pettigrew, Melinda M. ; Gent, Janneane F. ; Pyles, Richard ; Miller, Aaron L. ; Nokso-Koivisto, Johanna ; Chonmaitree, Tasnee. / Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection. In: Journal of Clinical Microbiology. 2011 ; Vol. 49, No. 11. pp. 3750-3755.
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