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Microbiological profile of adenoid hypertrophy correlates to clinical diagnosis in children.

Szalmás A, Papp Z, Csomor P, Kónya J, Sziklai I, Szekanecz Z, Karosi T - Biomed Res Int (2013)

Bottom Line: RAOM cases were significantly associated with biofilm existence (n = 20, P < 0.001).Showing a statistically significant correlation, all OME cases were positive for human bocavirus (HBoV, P < 0.001).Bacterial biofilms might contribute to the damage of respiratory epithelium and recurring acute infections resulting in RAOM.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Nagyerdei Krt. 98, Debrecen 4032, Hungary.

ABSTRACT

Objective: Adenoid hypertrophy is a common condition in childhood, which may be associated with recurring acute otitis media (RAOM), otitis media with effusion (OME), and obstructive sleep apnea syndrome (OSAS). These different clinical characteristics have some clinical overlap; however, they might be explained by distinct immunologic and infectious profiles and result in various histopathologic findings of adenoid specimens.

Methods: A total of 59 children with adenoid hypertrophy undergoing adenoidectomy were studied. Three series of identical adenoid specimens were processed to hematoxylin-eosin (H.E.) and Gram staining and to respiratory virus specific real-time PCR, respectively.

Results: According to the clinical characteristics, patients were recruited into three groups: RAOM (n = 25), OME (n = 19), and OSAS (n = 15). Bacterial biofilms were detected in 21 cases, while at least one of the studied respiratory viruses was detected in 52 specimens. RAOM cases were significantly associated with biofilm existence (n = 20, P < 0.001). In contrast, OME group was characterized by the absence of bacterial biofilm and by normal mucosa. Showing a statistically significant correlation, all OME cases were positive for human bocavirus (HBoV, P < 0.001).

Conclusions: Bacterial biofilms might contribute to the damage of respiratory epithelium and recurring acute infections resulting in RAOM. In OME cases persisting respiratory viruses, mainly HBoV, can cause subsequent lymphoid hyperplasia leading to ventilation disorders and impaired immunoreactivity of the middle ear cleft.

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Related in: MedlinePlus

Graphic representation of respiratory virus specific real-time PCR results in different patient groups. RAOM: recurring acute otitis media; OME: otitis media with effusion; OSAS: obstructive sleep apnea syndrome.
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fig1: Graphic representation of respiratory virus specific real-time PCR results in different patient groups. RAOM: recurring acute otitis media; OME: otitis media with effusion; OSAS: obstructive sleep apnea syndrome.

Mentions: According to the validated real-time PCR results, persisting A and B types of influenza virus (Iv-A and B) could not be detected in the adenoid specimens (Tables 2 and 3). The detectability of RSV and hMPV did not achieve a significant level and could be established as an accidental association in different patient groups (Tables 2–4). In contrast, RSV and hMPV were exclusively detected in the OME group. The mainly associated viral pathogens were originated from various serotypes of RV/EV, AdV, and HBoV species (Tables 2–4). Table 2 presents the individual coexpression patterns of different respiratory viruses. All virus-negative cases (n = 7) belonged to the RAOM group, while patients of OME and OSAS groups were all characterized by various coexpressions of respiratory viruses (Tables 3 and 4). The RAOM group was exclusively associated with the presence of RV/EV AdV species (Tables 3 and 4). In the OSAS group, HBoV was detected in 54% of cases, which was mainly coexpressed with RV/EV (20%) and AdV serotypes (27%) (Table 4, Figure 1). Only one case was characterized by individual persistence of HBoV (Table 4). All specimens of the OME group were characterized by HBoV (Tables 3 and 4, Figure 1). Furthermore, eight of nine cases with individual expression of HBoV belonged to the OME group (Table 4). It was found that individual presence (P < 0.001, Chi-square test) or codetection (P < 0.05, Chi-square test) of HBoV in the adenoid tissue is a strong predictor of OME associated with adenoid hypertrophy (Tables 3 and 4, Figure 1).


Microbiological profile of adenoid hypertrophy correlates to clinical diagnosis in children.

Szalmás A, Papp Z, Csomor P, Kónya J, Sziklai I, Szekanecz Z, Karosi T - Biomed Res Int (2013)

Graphic representation of respiratory virus specific real-time PCR results in different patient groups. RAOM: recurring acute otitis media; OME: otitis media with effusion; OSAS: obstructive sleep apnea syndrome.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3794625&req=5

fig1: Graphic representation of respiratory virus specific real-time PCR results in different patient groups. RAOM: recurring acute otitis media; OME: otitis media with effusion; OSAS: obstructive sleep apnea syndrome.
Mentions: According to the validated real-time PCR results, persisting A and B types of influenza virus (Iv-A and B) could not be detected in the adenoid specimens (Tables 2 and 3). The detectability of RSV and hMPV did not achieve a significant level and could be established as an accidental association in different patient groups (Tables 2–4). In contrast, RSV and hMPV were exclusively detected in the OME group. The mainly associated viral pathogens were originated from various serotypes of RV/EV, AdV, and HBoV species (Tables 2–4). Table 2 presents the individual coexpression patterns of different respiratory viruses. All virus-negative cases (n = 7) belonged to the RAOM group, while patients of OME and OSAS groups were all characterized by various coexpressions of respiratory viruses (Tables 3 and 4). The RAOM group was exclusively associated with the presence of RV/EV AdV species (Tables 3 and 4). In the OSAS group, HBoV was detected in 54% of cases, which was mainly coexpressed with RV/EV (20%) and AdV serotypes (27%) (Table 4, Figure 1). Only one case was characterized by individual persistence of HBoV (Table 4). All specimens of the OME group were characterized by HBoV (Tables 3 and 4, Figure 1). Furthermore, eight of nine cases with individual expression of HBoV belonged to the OME group (Table 4). It was found that individual presence (P < 0.001, Chi-square test) or codetection (P < 0.05, Chi-square test) of HBoV in the adenoid tissue is a strong predictor of OME associated with adenoid hypertrophy (Tables 3 and 4, Figure 1).

Bottom Line: RAOM cases were significantly associated with biofilm existence (n = 20, P < 0.001).Showing a statistically significant correlation, all OME cases were positive for human bocavirus (HBoV, P < 0.001).Bacterial biofilms might contribute to the damage of respiratory epithelium and recurring acute infections resulting in RAOM.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Nagyerdei Krt. 98, Debrecen 4032, Hungary.

ABSTRACT

Objective: Adenoid hypertrophy is a common condition in childhood, which may be associated with recurring acute otitis media (RAOM), otitis media with effusion (OME), and obstructive sleep apnea syndrome (OSAS). These different clinical characteristics have some clinical overlap; however, they might be explained by distinct immunologic and infectious profiles and result in various histopathologic findings of adenoid specimens.

Methods: A total of 59 children with adenoid hypertrophy undergoing adenoidectomy were studied. Three series of identical adenoid specimens were processed to hematoxylin-eosin (H.E.) and Gram staining and to respiratory virus specific real-time PCR, respectively.

Results: According to the clinical characteristics, patients were recruited into three groups: RAOM (n = 25), OME (n = 19), and OSAS (n = 15). Bacterial biofilms were detected in 21 cases, while at least one of the studied respiratory viruses was detected in 52 specimens. RAOM cases were significantly associated with biofilm existence (n = 20, P < 0.001). In contrast, OME group was characterized by the absence of bacterial biofilm and by normal mucosa. Showing a statistically significant correlation, all OME cases were positive for human bocavirus (HBoV, P < 0.001).

Conclusions: Bacterial biofilms might contribute to the damage of respiratory epithelium and recurring acute infections resulting in RAOM. In OME cases persisting respiratory viruses, mainly HBoV, can cause subsequent lymphoid hyperplasia leading to ventilation disorders and impaired immunoreactivity of the middle ear cleft.

Show MeSH
Related in: MedlinePlus