PATHOPHYSIOLOGY

NASOPHARYNGEAL FLORA IN THE FIRST THREE YEARS OF LIFE IN NORMAL AND OTITIS-PRONE CHILDREN

Faden H, Brodsky L, Waz MJ, Stanievich J, Bernstein J, Ogra P. Ann Otol Rhinol Laryngol. 1991;100:612-615

Purpose of the Study

The study was conducted to establish the types of middle ear bacterial pathogens found in the nasopharyngeal region of a group of normal children.

Study Population

A total of 110 demographically similar children aged 2 months to 3 years, who lived in the Greater Buffalo, New York, area, were enrolled in a 3-year prospective study of the natural history of otitis media as it relates to the nasopharyngeal bacterial flora. As the study progressed the group was divided into otitis-prone (OP) and non-otitis-prone (NOP) children.

Methods

The children had at least one visit every 3 months for the evaluation of the nasal passages and ears. They were examined by the same group of investigators for sick visits. At each visit, whether sick or well, cultures from the nasopharynx were obtained.

Findings

The OP children, even when well, were found to carry middle ear pathogens, Streptococcus pneumonniae, Moraxella catarrhalis, or nontypeable Haemophilus influenzae, at a rate statistically higher than the NOP group. When they were ill with a respiratory illness, the recovery rate of the same pathogens was again found to a greater degree in the OP children than the NOP ones. Of interest, H influenzae type B was not isolated in any nasopharyngeal culture.

Conclusions

The study is in general agreement with other published accounts, but the reason for this chronic carriage rate of middle ear pathogens in OP children remains unknown.

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