POLYMERASE CHAIN REACTION-BASED DETECTION OF RHINOVIRUS, RESPIRATORY SYNCYTIAL VIRUS, AND CORONAVIRUS IN OTITIS-MEDIA WITH EFFUSION

Objectives: To study the association of human rhinovirus (HRV), respir atory syncytial virus (RSV), and human coronavirus infections in child ren aged 6 months to 12 years with otitis media with effusion (OME). T o determine how Long HRV RNA can be detected after HRV infection. Meth ods: Middle ear effusion (MEE) samples collected at the time of tympan ostomy tube placement from 100 children with OME were examined. Viral RNA was detected by reverse-transcriptase polymerase chain reaction. F or HRV the results were compared with virus isolation in cell culture. In vitro studies of the persistence of HRV infectivity and RNA were c onducted by combining similar to 10(5) median cell culture infectious doses of HRV with pooled MEE at 37 degrees C and assaying serial sampl es for 12 weeks. Results: Virus RNA was detected in 30 children. HRV w as detected by reverse-transcriptase polymerase chain reaction in 19 c hildren with OME and by isolation in 5 children. RSV RNA was found in 8 and HCV in 3 children with OME. No dual viral infection was found. B acterial pathogens were isolated from 35 MEE samples and were associat ed with viral RNA in 11 cases, most often with HRV (9 cases). Under in vitro conditions, HRV culture positivity declined rapidly (<2 days), but RNA was detectable for up to 8 weeks. Conclusions: These results s uggest that virus infection, particularly HRV infection, either alone or concurrent with bacteria, is present in a larger percentage of chil dren with OME than previously suspected. It remains to be determined h ow often the presence of viral RNA in MEE represents persistent RNA, o ngoing viral replication, or recurrent infection.