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Viral URI, other factors increase risk for AOM in infants
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Recent research in Pediatrics indicated that viral upper respiratory tract infections, pathogenic bacterial colonization and lack of breast-feeding increased the risk for acute otitis media in children by age 1 year.
“We determined the prevalence of viral [upper respiratory tract infection (URI)] and its complications, including acute otitis media (AOM) and [lower respiratory tract infection (LRI)], and assessed the effect of bacterial-viral interactions, and genetic and environmental risks on acute otitis media development,” Tasnee Chonmaitree, MD, of the departments of pediatrics and pathology at the University of Texas Medical Branch, and colleagues wrote. “We clearly showed that frequent viral infections, bacterial colonization, and lack of breast-feeding are major AOM risk factors.”
Tasnee Chonmaitree
The researchers followed 367 healthy infants from birth to age 1 year for AOM development. Nasopharyngeal samples were collected at ages 1 to 6 months and at 9 months to determine bacterial colonization and for PCR studies. Samples also were collected during any diagnosed viral URIs.
Data showed that 887 URIs occurred in 305 study participants with 108 cases of AOM in 143 infants. Children with AOM had 4.7 URIs per child-year compared with 2.3 URIs per child-year among children without AOM (P < .002).
The researchers found that pathogenic bacterial colonization rates were greater in children with AOM vs. children without (P < .005). The results also indicated that breast-feeding reduced the risk for URIs and AOM (P <.05).
Chonmaitree and colleagues wrote that the presence of Moraxella catarrhalis, with or without other bacteria, altered the risk for URI (HR = 6.1; 95% CI, 4.04-9.23) and AOM (HR = 1; 95% CI, 0.62-1.6).
“During URI, presence of M. catarrhalis increased URI risk, regardless of the presence or absence of viruses,” Chonmaitree and colleagues wrote. “These complex viral-bacterial interactions may provide clues to the pathogenesis of URI and AOM, but studies using larger samples are needed.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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