Detection of rhinovirus, respiratory syncytial virus, and coronavirus infections in acute otitis media by reverse transcriptase polymerase chain reaction

Most common respiratory viruses are present in children with acute otitis media (AOM) and seem to actually be contributory to causing or increasing the risk of AOM. The viruses were found in 75% of 92 children between the ages of three months and seven years and included human rhinovirus (HRV), respiratory syncytial virus and coronavirus. HRV was the most common, found in 24% - 35% of the children with AOM. These tests reinforce, confirm and extend conclusions of earlier studies.
Objective. To determine the frequencies of human rhinovirus (HRV), respiratory syncytial virus (RSV), and coronavirus (HCV) infection in children with acute otitis media (AOM). Methods. Middle ear fluids (MEF) collected by tympanocentesis and nasopharyngeal aspirates (NPA) at the time of the AOM diagnosis were examined by reverse transcriptase polymerase chain reaction for HRV, RSV, and HCV RNA. Patients. Ninety-two children aged 3 months to 7 years during a 1-year period. Results. Virus RNA was detected in a total of 69 children (75%) and in 44 MEF samples (48%) and 57 NPA samples (62%) at the time of AOM diagnosis. HRV RNA was detected in both MEF and NPA in 18 (20%), in MEF alone in 4 (4%), and in NPA alone in 10 (11%). RSV was detected in both MEF and NPA in 12 (13%), in MEF alone in 5 (5%), and in NPA alone in 9 (10%). HCV RNA was detected in both MEF and NPA in 5 (5%), in MEF alone in 2 (2%), and in NPA alone in 9 (10%). Dual viral infections were detected in 5% of children. HRV and RSV were detected simultaneously in 2 MEF samples and in 2 NPA samples; RSV and HCV were detected in I NPA sample. Bacterial pathogens were detected in 56 (62%) MEF from 91 children. Viral RNA was detected in 20 (57%) MEF of 35 bacteria-negative and in 25 (45%) of 56 bacteria-positive MEF samples. No important differences in the risk of treatment failure, relapse, or occurrence of late secretory otitis media were noted between children with virus-positive and virus-negative MEF aspirates. Conclusion. These findings highlight the importance of common respiratory viruses, particularly HRV and RSV, in predisposing to and causing AOM in young children. Pediatrics 1998;102:291-295; RT-PCR, acute otitis media, rhinovirus, respiratory syncytial virus, coronavirus.
ABBREVIATIONS: AOM, acute otitis media; RSV, respiratory syncytial virus; HRV, human rhinovirus; RT-PCR, reverse transcriptase polymerase chain reaction; HCV human coronavirus; NPA, nasopharyngeal aspirates; MEF, middle ear fluids; PBS, phosphate-buffered [...]