Nasopharyngeal colonization of otopathogens in South Indian children with acute otitis media – A case control pilot study

SUMMARYIn order to study the epidemiology of acute otitis media (AOM) and Streptococcus pneumoniae nasopharyngeal colonization in the first 2 years of life, we followed up an unvaccinated birth cohort monthly and at visits when sick, with otoscopy to detect AOM and performed nasopharyngeal swabbing to detect S. pneumoniae. Serotyping of positive cultures was also performed. Of 210 babies who were enrolled at birth, 61 (29·05%) experienced 128 episodes of AOM [relative risk 2·63, 95% confidence interval (CI) 1·21–5·75] with maximum incidence in the second half of the first year of life. Episodes ranged from 1 to 7 (mean 2·1 episodes). Most (86·9%) babies with AOM had a positive culture swab giving an odds ratio (OR) of 1·93 (95% CI 1·03–3·62, P = 0·041) for this association. Other risk factors identified for AOM were winter season (OR 3·46, 95% CI 1·56–7·30, P = 0·001), upper respiratory infection (OR 2·43, 95% CI 1·43–4·51, P = 0·005); residents of small households were less likely to develop AOM (OR 0·32, 95% CI 0·17–0·57, P < 0·01). Common S. pneumoniae serotypes isolated during episodes were 19, 6, 15, 35, 7, 23, 9 and 10 which indicated a theoretical coverage for pneumococcal vaccines PCV10 and PCV13 constituent serotypes of 62·8%. We conclude that AOM in Indian infants is often associated with S. pneumoniae colonization of the nasopharynx as well as other risk factors.

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An intact bony tympanic facial canal does not protect from secondary facial paresis in adult acute otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215120000973 ◽

2020 ◽

Vol 134 (5) ◽

pp. 409-414

Author(s):

C Meerwein ◽

S Pazahr ◽

T M Stadler ◽

N Nierobisch ◽

A Dalbert ◽

...

Keyword(s):

Computed Tomography ◽

Otitis Media ◽

Case Control Study ◽

Acute Otitis Media ◽

Case Control ◽

Facial Canal ◽

Facial Paresis ◽

Retrospective Case ◽

Control Study

AbstractObjectiveTo investigate the prevalence of bony dehiscence in the tympanic facial canal in patients with acute otitis media with facial paresis compared to those without facial paresis.MethodA retrospective case–control study was conducted on acute otitis media patients with facial paresis undergoing high-resolution temporal bone computed tomography.ResultsForty-eight patients were included (24 per group). Definitive determination of the presence of a bony dehiscence was possible in 44 out of 48 patients (91.7 per cent). Prevalence of bony dehiscence in acute otitis media patients with facial paresis was not different from that in acute otitis media patients without facial paresis (p = 0.21). Presence of a bony dehiscence was associated with a positive predictive value of 66.7 per cent in regard to development of facial paresis. However, an intact bony tympanic facial canal did not prevent facial paresis in 44.8 per cent of cases (95 per cent confidence interval = 34.6–55.6).ConclusionPrevalence of bony dehiscence in acute otitis media patients with facial paresis did not differ from that in acute otitis media patients without facial paresis. An intact tympanic bony facial canal does not protect from facial paresis development.

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Correlation of higher antibody levels to pneumococcal proteins with protection from pneumococcal acute otitis media but not protection from nasopharyngeal colonization in young children

Clinical Microbiology and Infection ◽

10.1016/j.cmi.2017.01.011 ◽

2017 ◽

Vol 23 (7) ◽

pp. 487.e1-487.e6 ◽

Cited By ~ 4

Author(s):

Q. Xu ◽

J.R. Casey ◽

A. Almudevar ◽

M.E. Pichichero

Keyword(s):

Young Children ◽

Otitis Media ◽

Acute Otitis Media ◽

Nasopharyngeal Colonization ◽

Antibody Levels

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Changes Over Time in Nasopharyngeal Colonization in Children Under 2 Years of Age at the Time of Diagnosis of Acute Otitis Media (1999–2014)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy036 ◽

2018 ◽

Vol 5 (3) ◽

Cited By ~ 1

Author(s):

Judith M Martin ◽

Alejandro Hoberman ◽

Nader Shaikh ◽

Timothy Shope ◽

S onika Bhatnagar ◽

...

Keyword(s):

Otitis Media ◽

Susceptibility Testing ◽

Acute Otitis Media ◽

Initial Increase ◽

Prevalence Rates ◽

Nasopharyngeal Colonization ◽

Conjugate Vaccines ◽

Appropriate Treatment ◽

Changes Over Time ◽

Over Time

Abstract Background In children with acute otitis media (AOM), a decrease in nasopharyngeal (NP) colonization with vaccine serotypes of Streptococcus pneumoniae has been noted since the introduction of pneumococcal conjugate vaccines (PCVs). The purpose of this study is to describe corresponding changes in colonization with Haemophilus influenzae. Methods In 4 separate studies, we obtained NP cultures from children aged 6–23 months presenting with AOM. Cohort 1 was recruited before routine use of PCV7 (1999–2000); 93% of children in cohort 2 (2003–2005) and 100% in cohort 3 (2006–2009) received ≥2 doses of PCV7. All children in cohort 4 (2012–2014) received ≥2 doses of PCV13. Isolates of H. influenzae were tested for ß-lactamase production; ß-lactamase negative isolates from cohorts 3 and 4 underwent susceptibility testing. Results A total of 899 children were evaluated. NP colonization with H. influenzae was found in 26% of children in cohort 1 (n = 175), 41% in cohort 2 (n = 87), 33% in cohort 3 (n = 282), and 29% in cohort 4 (n = 355). Colonization with H. influenzae increased initially from cohort 1 to cohort 2 (P = .01), then decreased across cohorts 2, 3, and 4 (P = .03, test for trend). The prevalence rates of ß-lactamase production were 27%, 42%, 33%, and 30% in each of the 4 cohorts, respectively (P = .50). Conclusions Although an initial increase in H. influenzae colonization was observed, suggesting an impact of PCVs, the most recent prevalence rates of NP colonization with H. influenzae and ß-lactamase production were like those observed before universal administration of PCV7. This knowledge is critical to guide appropriate treatment recommendations for children with AOM.

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Pneumococcal Otitis Media following Middle Ear Deflation

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948109000119 ◽

1981 ◽

Vol 90 (1) ◽

pp. 72-76 ◽

Cited By ~ 13

Author(s):

William L. Meyerhoff ◽

G. Scott Giebink ◽

Donald Shea

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Endolymphatic Hydrops ◽

Acute Otitis Media ◽

Scala Tympani ◽

Nasopharyngeal Colonization ◽

Normal Morphology ◽

Time Period ◽

Middle Ear Pressure ◽

Histologic Changes

Temporal bone histology has been studied in chinchillas following middle ear deflation in the presence of nasopharyngeal colonization with S pneumoniae. All animals sacrificed within one hour following deflation had similar middle ear hsitology regardless of whether or not the animals had been colonized with S pneumoniae. All animals with negative nasopharyngeal culture for S pneumoniae sacrificed from 3–24 days following − 30 mm Hg negative middle ear pressure had negative middle ear cultures and normal morphology. During the same time period, however, nearly 60% of animals colonized with S pneumoniae developed acute otitis media with positive middle ear cultures for S pneumoniae. Histologic changes in the middle ear included the presence of effusion, leukocytes, granulation tissue, osteoneogenesis, mucosal metaplasia, and hemorrhage. Changes in the inner ear were much less frequent and included some leukocyte infiltration with hyperemia in the scala tympani and endolymphatic hydrops.

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Role of diet in ECC affected South Indian children assessed by the HEI-2005: A pilot study

Journal of Family Medicine and Primary Care ◽

10.4103/jfmpc.jfmpc_851_19 ◽

2020 ◽

Vol 9 (2) ◽

pp. 985

Author(s):

Deepa Gurunathan ◽

Pragyna Priyadarshini

Keyword(s):

Pilot Study ◽

Indian Children ◽

South Indian

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Gagging Assessment Scale: A Reliable Tool For Assessing Association Between Gagging And Dental Fear In Children Prior Dental Treatment- A Cross-Sectional Pilot Study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i4.4890 ◽

2021 ◽

Vol 12 (4) ◽

pp. 2469-2484

Author(s):

Pragyna Priyadarshini ◽

Deepa Gurunathan

Keyword(s):

Pilot Study ◽

Dental Treatment ◽

Dental Fear ◽

Assessment Scale ◽

Treatment Modalities ◽

Indian Children ◽

Cross Sectional ◽

Reliable Tool ◽

South Indian ◽

Fear And Anxiety

Gagging is a normal protective defence mechanism of our body that prevents entry of foreign bodies into the airway, which can create undue havoc during dental treatment especially in children. The present study aims to assess the prevalence of gagging and any of its existing association with dental fear and anxiety in children prior to dental treatment. A cross-sectional pilot study design was conducted in South Indian children (age group: 3-10 years) having no history of underlying psychological and systemic ailment. Different assessment scales of gagging (Gagging Assessment Scale [GAS], Shorter Objective Form of Gagging Problem Assessment [GPA-SF]/OGPA), dental fear (Children’s Fear Survey Schedule Dental Subscale [CFSS-DS]) and anxiety (Modified Dental Anxiety Scale- Faces [MDASF]) were administered to evaluate their response prior to the treatment. Younger children specifically females demonstrated severity of gagging reflex, which was directly correlated to their higher perception of dental fear and anxiety. However, no conclusive evidence of an association between gagging, dental fear and anxiety was ascertained. Prior knowledge of the gagging problem in children can help clinicians to effectively modify the treatment modalities for successful outcomes, while GAS could be a reliable tool for assessing its severity in children prior to dental treatment.

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