DETECTION OF RHINOVIRUS, RESPIRATORY SYNCYTIAL VIRUS, AND CORONAVIRUSINFECTIONS IN ACUTE OTITIS-MEDIA BY REVERSE-TRANSCRIPTASE POLYMERASE-CHAIN-REACTION

Objective. To determine the frequencies of human rhinovirus (HRV), res piratory syncytial virus (RSV), and coronavirus (HCV) infection in chi ldren with acute otitis media (AOM). Methods. Middle ear fluids (MEF) collected by tympanocentesis and nasopharyngeal aspirates (NPA) at the time of the AOM diagnosis were examined by reverse transcriptase poly merase chain reaction for HRV, RSV, and HCV RNA. Patients. Ninety-two children aged 3 months to 7 years during a 1-year period.Results. Viru s RNA was detected in a total of 69 children (75%) and in 44 MEF sampl es (48%) and 57 NPA samples (62%) at the time of AOM diagnosis. HRV RN A was detected in both MEF and NPA in 18 (20%), in MEF alone in 4 (4%) , and in NPA alone in 10 (11%). :RSV was detected in both MEF and NPA in 12 (13%), in MEF alone in 5 (5%), and in NPA alone in 9 (10%). HCV RNA was detected in both MEF and NPA in 5 (5%), in MEF alone in 2 (2%) , and in NPA alone in 9 (10%). Dual viral infections were detected in 5% of children. HRV and RSV were detected simultaneously in 2 MEF samp les and in 2 NP,4 samples; RSV and HCV were detected in 1 NPA sample. Bacterial pathogens were detected in 56 (62%) MEF from 91 children. Vi ral RNA was detected in 20 (57%) MEF of 35 bacteria-negative and in 25 (45%) of 56 bacteria-positive MEF samples. No important differences i n the risk of treatment failure, relapse, or occurrence of late secret ory otitis media were noted between children with virus-positive and v irus-negative MEF aspirates. Conclusion. These findings highlight the importance of common respiratory viruses, particularly HRV and RSV, ir e predisposing to and causing AOM in young children.