소아 삼출성 중이염에서 중합효소연쇄반응(PCR)을 이용한 진균 및 세균의 검출과 관련된 임상 인자의 분석
Detection of Fungus and Bacteria in Otitis Media with Effusion of Children Using Polymerase Chain Reaction and Its Correlation of Clinical Factors
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Several hypotheses have been proposed in the etiopathogenesis of otitis media with effusion (OME). The bacterial or fungal infection may also play a major role in the pathogenesis of OME. To investigate the relationship between bacteria and fungi as pathogens in OME and to analyze the incidence, the authors evaluated the pathogens of OME using polymerase chain reaction (PCR) technique, which is known to be more sensitive and specific than conventional bacterial and fungal culture. Subjects and Method：Twenty-three children (thirty ears), who were diagnosed with OME and had underwent ventilation tube insertion, were evaluated in the department of ORL-HNS, University Hospital, from May 2006 to March 2007. The middle ear effusion, obtained during the procedure, was evaluated for the identification of bacteria and fungi by PCR. Results：Among 30 ears, viable pathogenic bacteria were detected in 20 ears (66.6%) and fungi in 13 ears (43.3%). The bacterial pathogens included Haemophilus influenzae (13 ears), followed by Streptococcus pneumonize (6 ears). The fungi detected from PCR were Candida albicans (4 ears-30.8%), Aspergillus niger (2 ears-15.4%) and Paecilomyces lilacinus (2 ears-15.4%). Additional pathogens include Basidiomycete yeast, Saccharamycete sp., Eurotium rubrum, Dothioraceae sp. and Stemphylium solani. Detection of fungal DNA was more common in patients with cleft palate and in recurrent cases with statistical significance. Conclusion： The use of PCR of middle ear effusion is effective for the detection of pathogens in patients with OME. While bacteria were thought to be the causative pathogen, this study suggests the etiological role of fungi in the pathogenesis of OME. However, the relationship between fungi and OME requires further studies. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:960-6)
Abstract
Several hypotheses have been proposed in the etiopathogenesis of otitis media with effusion (OME). The bacterial or fungal infection may also play a major role in the pathogenesis of OME. To investigate the relationship between bacteria and fungi as pathogens in OME and to analyze the incidence, the authors evaluated the pathogens of OME using polymerase chain reaction (PCR) technique, which is known to be more sensitive and specific than conventional bacterial and fungal culture. Subjects and Method：Twenty-three children (thirty ears), who were diagnosed with OME and had underwent ventilation tube insertion, were evaluated in the department of ORL-HNS, University Hospital, from May 2006 to March 2007. The middle ear effusion, obtained during the procedure, was evaluated for the identification of bacteria and fungi by PCR. Results：Among 30 ears, viable pathogenic bacteria were detected in 20 ears (66.6%) and fungi in 13 ears (43.3%). The bacterial pathogens included Haemophilus influenzae (13 ears), followed by Streptococcus pneumonize (6 ears). The fungi detected from PCR were Candida albicans (4 ears-30.8%), Aspergillus niger (2 ears-15.4%) and Paecilomyces lilacinus (2 ears-15.4%). Additional pathogens include Basidiomycete yeast, Saccharamycete sp., Eurotium rubrum, Dothioraceae sp. and Stemphylium solani. Detection of fungal DNA was more common in patients with cleft palate and in recurrent cases with statistical significance. Conclusion： The use of PCR of middle ear effusion is effective for the detection of pathogens in patients with OME. While bacteria were thought to be the causative pathogen, this study suggests the etiological role of fungi in the pathogenesis of OME. However, the relationship between fungi and OME requires further studies. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:960-6)
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