Recurrent acute otitis media - aetiology, diagnostics and prevention
Author
Summary, in English
Prediction of the causative pathogen can support the decision of whether or not to prescribe antibiotics for AOM. The rapid pneumococcal urine test Binax NOW was tried on nasopharyngeal and middle ear secretions and was found to have a high sensitivity and specificity for detecting pneumococci in these fluids.
About 10% of children suffer from recurrent AOM (rAOM). During the last decade, childhood vaccines against S. pneumoniae have been introduced. Vaccination causes a modest reduction of AOM episodes. Whether children with rAOM benefit more than others from vaccination was investigated in a study on young children with an early AOM onset. Vaccination caused a 26% reduction in AOM episodes among children with rAOM.
Knowledge of nasopharyngeal carriage patterns in rAOM children might help in developing new preventive strategies. Children in the vaccine study were rapidly colonized with otitis pathogens. H. influenzae was difficult to eradicate for these children, and was frequently carried during both sickness and health.
Although hereditary factors are known to be important, it is still unclear why some children contract rAOM. We found that deficiencies of the immunological markers IgG2, MBL and C1q were frequent among rAOM children.
Department/s
Publishing year
2011
Language
English
Publication/Series
Lund University Faculty of Medicine Doctoral Dissertation Series
Volume
2011:111
Document type
Dissertation
Publisher
Faculty of Medicine, Lund University
Topic
- Otorhinolaryngology
Keywords
- Binax NOW
- immunological aberrations
- immune deficiency
- Haemophilus influenzae
- Streptococcus pneumoniae
- nasopharyngeal colonization
- conjugate pneumococcal vaccine
- Acute otitis media
- recurrent acute otitis media
Status
Published
Supervisor
- Ann Hermansson
- Åsa Melhus
ISBN/ISSN/Other
- ISSN: 1652-8220
- ISBN: 978-91-86871-61-1
Defence date
10 December 2011
Defence time
09:15
Defence place
Hörsalen, Palaestra et Odeum
Opponent
- Anne Schilder (Professor)