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Tasnee Chonmaitree - One of the best experts on this subject based on the ideXlab platform.

  • importance of viruses in Acute Otitis Media
    Current Opinion in Pediatrics, 2015
    Co-Authors: Johanna Noksokoivisto, Tal Marom, Tasnee Chonmaitree
    Abstract:

    Purpose of review Acute Otitis Media (AOM) occurs as a complication of viral upper respiratory tract infection (URI). Bacterial otopathogens and respiratory viruses interact and play important roles in AOM development. Better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease.

  • viral bacterial interactions and risk of Acute Otitis Media complicating upper respiratory tract infection
    Journal of Clinical Microbiology, 2011
    Co-Authors: Melinda M Pettigrew, Janneane F Gent, Richard B Pyles, Aaron L Miller, Johanna Noksokoivisto, Tasnee Chonmaitree
    Abstract:

    Acute Otitis Media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of Acute Otitis Media associated with specific combinations of respiratory viruses and Acute Otitis Media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of Acute Otitis Media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P < 0.05 by χ(2) test). Children with high respiratory syncytial virus loads (≥3.16 × 10(7) copies/ml) experienced increased Acute Otitis Media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with Acute Otitis Media. In adjusted models controlling for the presence of key viruses, bacteria, and Acute Otitis Media risk factors, Acute Otitis Media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute Otitis Media risk differs by the specific viruses and bacteria involved. Acute Otitis Media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to Acute Otitis Media bacterial pathogens.

  • incidence of Acute Otitis Media and sinusitis complicating upper respiratory tract infection the effect of age
    Pediatrics, 2007
    Co-Authors: Krystal Revai, Laura A Dobbs, Sangeeta Nair, Janak A Patel, James J Grady, Tasnee Chonmaitree
    Abstract:

    Infants and young children are prone to developing upper respiratory tract infections, which often result in bacterial complications such as Acute Otitis Media and sinusitis. We evaluated 623 upper respiratory tract infection episodes in 112 children (6–35 months of age) to determine the proportion of upper respiratory tract infection episodes that result in Acute Otitis Media or sinusitis. Of all upper respiratory tract infections, 30% were complicated by Acute Otitis Media and 8% were complicated by sinusitis. The rate of Acute Otitis Media after upper respiratory tract infection declined with increasing age, whereas the rate of sinusitis after upper respiratory tract infection peaked in the second year of life. Risk for Acute Otitis Media may be reduced substantially by avoiding frequent exposure to respiratory viruses (eg, avoidance of day care attendance) in the first year of life.

  • otoscopic and tympanometric findings in Acute Otitis Media yielding dry tap at tympanocentesis
    Pediatric Infectious Disease Journal, 2004
    Co-Authors: Kokab Saeed, Carol Lynn Coglianese, David P Mccormick, Tasnee Chonmaitree
    Abstract:

    Background:The value of tympanometry in detection of middle ear effusion (MEE) has been widely studied in Otitis Media with effusion. There has been no direct comparison of tympanometric and tympanocentesis (TAP) findings in Acute Otitis Media (AOM). We compared otoscopic, tympanometric and TAP find

  • importance of respiratory viruses in Acute Otitis Media
    Clinical Microbiology Reviews, 2003
    Co-Authors: Terho Heikkinen, Tasnee Chonmaitree
    Abstract:

    Acute Otitis Media is usually considered a simple bacterial infection that is treated with antibiotics. However, ample evidence derived from studies ranging from animal experiments to extensive clinical trials supports a crucial role for respiratory viruses in the etiology and pathogenesis of Acute Otitis Media. Viral infection of the upper respiratory mucosa initiates the whole cascade of events that finally leads to the development of Acute Otitis Media as a complication. The pathogenesis of Acute Otitis Media involves a complex interplay between viruses, bacteria, and the host’s inflammatory response. In a substantial number of children, viruses can be found in the middle-ear fluid either alone or together with bacteria, and recent studies indicate that at least some viruses actively invade the middle ear. Viruses appear to enhance the inflammatory process in the middle ear, and they may significantly impair the resolution of Otitis Media. Prevention of the predisposing viral infection by vaccination against the major viruses would probably be the most effective way to prevent Acute Otitis Media. Alternatively, early treatment of the viral infection with specific antiviral agents would also be effective in reducing the occurrence of Acute Otitis Media.

Harvey Coates - One of the best experts on this subject based on the ideXlab platform.

  • igg responses to pneumococcal and haemophilus influenzae protein antigens are not impaired in children with a history of recurrent Acute Otitis Media
    PLOS ONE, 2012
    Co-Authors: Selma P Wiertsema, Karli J Corscadden, Eva N Mowe, Guicheng Zhang, Shyan Vijayasekaran, Harvey Coates, Timothy J Mitchell, W R Thomas, Peter Richmond
    Abstract:

    Background Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) have the potential to reduce the burden of Acute Otitis Media. Little is known about the antibody response to such antigens in young children with recurrent Acute Otitis Media, however, it has been suggested antibody production may be impaired in these children. Methods We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply) and 3 NTHi (P4, P6 and PD) proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent Acute Otitis Media (Median 7 episodes, requiring ventilation tube insertion) and 63 healthy age-matched controls, using a newly developed multiplex bead assay. Results Children with a history of recurrent Acute Otitis Media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of Acute Otitis Media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. Conclusions Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of Acute Otitis Media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent Acute Otitis Media should be reconsidered.

  • high detection rates of nucleic acids of a wide range of respiratory viruses in the nasopharynx and the middle ear of children with a history of recurrent Acute Otitis Media
    Journal of Medical Virology, 2011
    Co-Authors: Selma P Wiertsema, Karli J Corscadden, Eva N Mowe, Shyan Vijayasekaran, Harvey Coates, Glenys Chidlow, Leaann S Kirkham
    Abstract:

    Both bacteria and viruses play a role in the development of Acute Otitis Media, however, the importance of specific viruses is unclear. In this study molecular methods were used to determine the presence of nucleic acids of human rhinoviruses (HRV; types A, B, and C), respiratory syncytial viruses (RSV; types A and B), bocavirus (HBoV), adenovirus, enterovirus, coronaviruses (229E, HKU1, NL63, and OC43), influenza viruses (types A, B, and C), parainfluenza viruses (types 1, 2, 3, 4A, and 4B), human metapneumovirus, and polyomaviruses (KI and WU) in the nasopharynx of children between 6 and 36 months of age either with (n = 180) or without (n = 66) a history of recurrent Acute Otitis Media and in 238 middle ear effusion samples collected from 143 children with recurrent Acute Otitis Media. The co-detection of these viruses with Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis was analyzed. HRV (58.3% vs. 42.4%), HBoV (52.2% vs. 19.7%), polyomaviruses (36.1% vs. 15.2%), parainfluenza viruses (29.4% vs. 9.1%), adenovirus (25.0% vs. 6.1%), and RSV (27.8% vs. 9.1%) were detected significantly more often in the nasopharynx of children with a history of recurrent Acute Otitis Media compared to healthy children. HRV was predominant in the middle ear and detected in middle ear effusion of 46% of children. Since respiratory viruses were detected frequently in the nasopharynx of both children with and without a history of recurrent Acute Otitis Media, the etiological role of specific viruses in recurrent Acute Otitis Media remains uncertain, however, anti-viral therapies may be beneficial in future treatment and prevention strategies for Acute Otitis Media.

  • high detection rates of nucleic acids of a wide range of respiratory viruses in the nasopharynx and the middle ear of children with a history of recurrent Acute Otitis Media
    Journal of Medical Virology, 2011
    Co-Authors: Selma P Wiertsema, Karli J Corscadden, Eva N Mowe, Shyan Vijayasekaran, Harvey Coates, Glenys Chidlow, Leaann S Kirkham
    Abstract:

    Both bacteria and viruses play a role in the development of Acute Otitis Media, however, the importance of specific viruses is unclear. In this study molecular methods were used to determine the presence of nucleic acids of human rhinoviruses (HRV; types A, B, and C), respiratory syncytial viruses (RSV; types A and B), bocavirus (HBoV), adenovirus, enterovirus, coronaviruses (229E, HKU1, NL63, and OC43), influenza viruses (types A, B, and C), parainfluenza viruses (types 1, 2, 3, 4A, and 4B), human metapneumovirus, and polyomaviruses (KI and WU) in the nasopharynx of children between 6 and 36 months of age either with (n = 180) or without (n = 66) a history of recurrent Acute Otitis Media and in 238 middle ear effusion samples collected from 143 children with recurrent Acute Otitis Media. The co-detection of these viruses with Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis was analyzed. HRV (58.3% vs. 42.4%), HBoV (52.2% vs. 19.7%), polyomaviruses (36.1% vs. 15.2%), parainfluenza viruses (29.4% vs. 9.1%), adenovirus (25.0% vs. 6.1%), and RSV (27.8% vs. 9.1%) were detected significantly more often in the nasopharynx of children with a history of recurrent Acute Otitis Media compared to healthy children. HRV was predominant in the middle ear and detected in middle ear effusion of 46% of children. Since respiratory viruses were detected frequently in the nasopharynx of both children with and without a history of recurrent Acute Otitis Media, the etiological role of specific viruses in recurrent Acute Otitis Media remains uncertain, however, anti-viral therapies may be beneficial in future treatment and prevention strategies for Acute Otitis Media. J. Med. Virol. 83:2008–2017, 2011. © 2011 Wiley-Liss, Inc.

Terho Heikkinen - One of the best experts on this subject based on the ideXlab platform.

  • importance of respiratory viruses in Acute Otitis Media
    Clinical Microbiology Reviews, 2003
    Co-Authors: Terho Heikkinen, Tasnee Chonmaitree
    Abstract:

    Acute Otitis Media is usually considered a simple bacterial infection that is treated with antibiotics. However, ample evidence derived from studies ranging from animal experiments to extensive clinical trials supports a crucial role for respiratory viruses in the etiology and pathogenesis of Acute Otitis Media. Viral infection of the upper respiratory mucosa initiates the whole cascade of events that finally leads to the development of Acute Otitis Media as a complication. The pathogenesis of Acute Otitis Media involves a complex interplay between viruses, bacteria, and the host’s inflammatory response. In a substantial number of children, viruses can be found in the middle-ear fluid either alone or together with bacteria, and recent studies indicate that at least some viruses actively invade the middle ear. Viruses appear to enhance the inflammatory process in the middle ear, and they may significantly impair the resolution of Otitis Media. Prevention of the predisposing viral infection by vaccination against the major viruses would probably be the most effective way to prevent Acute Otitis Media. Alternatively, early treatment of the viral infection with specific antiviral agents would also be effective in reducing the occurrence of Acute Otitis Media.

  • prevalence of various respiratory viruses in the middle ear during Acute Otitis Media
    The New England Journal of Medicine, 1999
    Co-Authors: Terho Heikkinen, Monica Thint, Tasnee Chonmaitree
    Abstract:

    Background Vaccines against respiratory viruses may be able to reduce the frequency of Acute Otitis Media. Although the role of respiratory viruses in the pathogenesis of Acute Otitis Media is well established, the relative importance of various viruses is unknown. Methods We determined the prevalence of various respiratory viruses in the middle-ear fluid in 456 children (age, two months to seven years) with Acute Otitis Media. At enrollment and after two to five days of antibiotic therapy, specimens of middle-ear fluid and nasal-wash specimens were obtained for viral and bacterial cultures and the detection of viral antigens. The viral cause of the infections was also assessed by serologic studies of serum samples obtained during the Acute illness and convalescence. Results A specific viral cause of the respiratory tract infections was identified in 186 of the 456 children (41 percent). Respiratory syncytial virus was the most common virus identified in middle-ear fluid: it was detected in the middle-ear...

  • influenza vaccination in the prevention of Acute Otitis Media in children
    JAMA Pediatrics, 1991
    Co-Authors: Terho Heikkinen, Olli Ruuskanen, Matti Waris, Thedi Ziegler, Mikko Arola, Pekka Halonen
    Abstract:

    • We studied a new approach to the prevention of Acute Otitis Media through the administration of influenza vaccine to 187 day-care center children aged 1 to 3 years before the influenza A epidemic of 1988-1989. The control group consisted of 187 unvaccinated children of similar age and background. During the 6-week study period, influenza A infection was diagnosed in five (3%) of 187 vaccines and in 29 (16%) of 187 controls. Acute Otitis Media developed in three (60%) of five vaccines with an influenza A infection compared with 18 (67%) of 27 controls (excluded were two children with a double viral infection). The incidence of Acute Otitis Media associated with influenza A was reduced by 83% in the vaccines. The total number of children with Acute Otitis Media in the vaccine group was 35, compared with 55 in the control group, disclosing a 36% reduction among the vaccinees. We conclude that influenza vaccination decreases the incidence of Acute Otitis Media in children during an influenza A epidemic, suggesting also that other vaccines against respiratory viruses may be an effective way to reduce the incidence of Acute Otitis Media. ( AJDC . 1991;145:445-448)

Marcia Kurslasky - One of the best experts on this subject based on the ideXlab platform.

  • shortened antimicrobial treatment for Acute Otitis Media in young children
    The New England Journal of Medicine, 2016
    Co-Authors: Alejandro Hoberman, Jack L Paradise, Howard E. Rockette, Marcia Kurslasky, Diana H Kearney, Sonika Bhatnagar, Timothy R Shope, Judith M Martin, Susan J Copelli, Kathleen D Colborn
    Abstract:

    BackgroundLimiting the duration of antimicrobial treatment constitutes a potential strategy to reduce the risk of antimicrobial resistance among children with Acute Otitis Media. MethodsWe assigned 520 children, 6 to 23 months of age, with Acute Otitis Media to receive amoxicillin–clavulanate either for a standard duration of 10 days or for a reduced duration of 5 days followed by placebo for 5 days. We measured rates of clinical response (in a systematic fashion, on the basis of signs and symptomatic response), recurrence, and nasopharyngeal colonization, and we analyzed episode outcomes using a noninferiority approach. Symptom scores ranged from 0 to 14, with higher numbers indicating more severe symptoms. ResultsChildren who were treated with amoxicillin–clavulanate for 5 days were more likely than those who were treated for 10 days to have clinical failure (77 of 229 children [34%] vs. 39 of 238 [16%]; difference, 17 percentage points [based on unrounded data]; 95% confidence interval, 9 to 25). The m...

  • emergence of streptococcus pneumoniae serogroups 15 and 35 in nasopharyngeal cultures from young children with Acute Otitis Media
    Pediatric Infectious Disease Journal, 2014
    Co-Authors: Judith M Martin, Jack L Paradise, Alejandro Hoberman, Sonika Bhatnagar, Timothy R Shope, Nader Shaikh, Mary Ann Haralam, Stan L Block, Karen A Barbadora, Marcia Kurslasky
    Abstract:

    Background Surveillance of children with Acute Otitis Media (AOM) for nasopharyngeal colonization with Streptococcus pneumoniae before, during, and after the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) indicated the near-complete elimination of PCV7 strains and the emergence of pneumococcal serotype 19A.

  • treatment of Acute Otitis Media in children under 2 years of age
    The New England Journal of Medicine, 2011
    Co-Authors: Alejandro Hoberman, Jack L Paradise, Howard E. Rockette, Kathleen D Colborn, Marcia Kurslasky, Ellen R Wald, Diana H Kearney, Sonika Bhatnagar, Nader Shaikh, Mary Ann Haralam
    Abstract:

    Background Recommendations vary regarding imMediate antimicrobial treatment versus watchful waiting for children younger than 2 years of age with Acute Otitis Media. Methods We randomly assigned 291 children 6 to 23 months of age, with Acute Otitis Media diagnosed with the use of stringent criteria, to receive amoxicillin–clavulanate or placebo for 10 days. We measured symptomatic response and rates of clinical failure. Results Among the children who received amoxicillin–clavulanate, 35% had initial resolution of symptoms by day 2, 61% by day 4, and 80% by day 7; among children who received placebo, 28% had initial resolution of symptoms by day 2, 54% by day 4, and 74% by day 7 (P=0.14 for the overall comparison). For sustained resolution of symptoms, the corresponding values were 20%, 41%, and 67% with amoxicillin–clavulanate, as compared with 14%, 36%, and 53% with placebo (P=0.04 for the overall comparison). Mean symptom scores over the first 7 days were lower for the children treated with amoxicillin–...

  • responsiveness and construct validity of a symptom scale for Acute Otitis Media
    Pediatric Infectious Disease Journal, 2009
    Co-Authors: Nader Shaikh, Jack L Paradise, Howard E. Rockette, Marcia Kurslasky, Alejandro Hoberman, Diana H Kearney, D K Colborn, Lisa Zoffel
    Abstract:

    Background:Because resolution of symptoms is a primary goal of antimicrobial therapy in children with Acute Otitis Media (AOM), measurement of symptoms in studies of antimicrobial effectiveness in such children is important. We have developed a scale for measuring symptoms of AOM in young children (

  • adenoidectomy and adenotonsillectomy for recurrent Acute Otitis Media parallel randomized clinical trials in children not previously treated with tympanostomy tubes
    JAMA, 1999
    Co-Authors: Jack L Paradise, Beverly S Bernard, Clyde G Smith, Howard E. Rockette, Kathleen D Colborn, Charles D. Bluestone, Marcia Kurslasky
    Abstract:

    ContextAdenoidectomy and adenotonsillectomy are commonly performed in US children to reduce the occurrence of persistent or recurrent Otitis Media, but evidence supporting the efficacy of the operations is limited.ObjectivesTo test the efficacy of adenoidectomy and adenotonsillectomy in children with persistent or recurrent Otitis Media who had not previously undergone tube placement and to compare the relative efficacy of adenoidectomy alone vs adenotonsillectomy in such children.DesignTwo parallel randomized clinical trials.Setting and ParticipantsA total of 461 children aged 3 to 15 years were enrolled at Children's Hospital of Pittsburgh, Pa, between April 1980 and April 1994. Four hundred ten children were observed for up to 3 years.InterventionsChildren without recurrent throat infection or tonsillar hypertrophy (304 enrolled; 266 followed up) were randomized to either an adenoidectomy, adenotonsillectomy, or control group; children who had such conditions (157 enrolled; 144 followed up) were randomized to an adenotonsillectomy or control group.Main Outcome MeasuresOccurrence rate of episodes of Acute Otitis Media by treatment group and estimated proportion of time with Otitis Media.ResultsIn both trials, most subjects were eligible because of recurrent Acute Otitis Media, with or without persistent Otitis Media with effusion. A total of 47 children assigned to surgical treatment groups had no surgery. The efficacy of surgery in both trials was modest and limited mainly to the first follow-up year. The largest differences in that year were found in the 3-way trial between the adenotonsillectomy group and the control group: mean annual rate of episodes of Acute Otitis Media, 1.4 vs 2.1 (P<.001); and mean estimated percentage of time with Otitis Media, 18.6% vs 29.9% (difference, 11.3%; 95% confidence interval, 4.4%-18.2%; P=.002). Perioperative and postoperative complications or other adverse events occurred not infrequently, especially among subjects undergoing adenotonsillectomy (14.6%).ConclusionsOur study showed limited and short-term efficacy of both adenoidectomy and adenotonsillectomy; given the risks, morbidity, and costs of these procedures, these data suggest that neither operation should ordinarily be considered as a first surgical intervention in children whose only indication is recurrent Acute Otitis Media.

Laura A Dobbs - One of the best experts on this subject based on the ideXlab platform.