Biofilm Density in the Pediatric Nasopharynx: Recurrent Acute Otitis Media versus Obstructive Sleep Apnea

Zuliani, Giancarlo; Carlisle, Michael P.; Duberstein, Aaron; Haupert, Michael; Md, Mausumi N Syamal; Berk, Richard S.; Du, Wei; Coticchia, James M.

doi:10.1177/000348940911800711

Cited by 38 publications

(36 citation statements)

References 19 publications

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“…An increase in biofilm density on the adenoid surface also occurs in children with recurrent or persistent otitis media [36]. Therefore, we further studied the biofilm activity of MRSA and MSSA in vivo and in vitro.…”

Section: Discussionmentioning

confidence: 99%

Association of adenoid hyperplasia and bacterial biofilm formation in children with adenoiditis in Taiwan

Lin

Tsai

et al. 2011

Eur Arch Otorhinolaryngol

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The adenoid is a bacterial reservoir that contributes to chronic otolaryngologic infections. Staphylococcus aureus (S. aureus) is a common pathogen in the adenoid. The increase of antibiotic resistance in S. aureus has become an important issue in public health. The aim of this study was to compare adenoid hyperplasia and biofilm formation in children with S. aureus adenoiditis in Taiwan. The patients were divided into methicillin-resistant and methicillin-sensitive S. aureus groups according to the S. aureus obtained from adenoid tissue after antibiotic susceptibility testing. Adenoid hyperplasia was assessed by lateral cephalometry, and the severity of sinusitis was evaluated by Water's view. Microbiological investigation of available S. aureus isolates was performed by in vivo morphological observation and an in vitro bacterial biofilm assay. Sixty isolates of S. aureus were identified in 283 children (21.2%) after adenoidectomy, of which 21 (35%) were methicillin-resistant S. aureus (MRSA). The severity of adenoid hyperplasia and extensive biofilm formation were more prominent in patients infected with methicillin-resistant S. aureus than in those infected with methicillin-sensitive S. aureus (MSSA). The primary outcome of this study was to provide evidence that S. aureus constituted a significant portion of the adenoidal pathogens. The secondary outcome of this study was that MRSA adenoiditis may be associated with adenoid hyperplasia and biofilm formation.

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Section: Discussionmentioning

confidence: 99%

Association of adenoid hyperplasia and bacterial biofilm formation in children with adenoiditis in Taiwan

Lin

Tsai

et al. 2011

Eur Arch Otorhinolaryngol

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“…The assembly of these bacteria and other microbes into biofilms has also been implicated for the recalcitrance of AOM [12] . Biofilms are microbial communities where bacterial interactions (e.g., symbiotic, antagonistic) influence the composition and stability of biofilms.…”

Section: Discussionmentioning

confidence: 99%

“…Current literature also supports the presence of microbial biofilms in AOM which impart microbial resistance to antibiotic treatments and may lead to the recurrence of AOM [11,12] . Although biofilms are commonly associated with disease, certain biofilms can be beneficial or harmless [13,14] .…”

Section: Introductionmentioning

confidence: 93%

The Adenoid Microbiome in Recurrent Acute Otitis Media and Obstructive Sleep Apnea

Dirain¹,

Silva²,

Collins³

et al. 2017

Int Adv Otol

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OBJECTIVE:To compare the microbial flora of adenoids from patients with recurrent acute otitis media (AOM) and patients with obstructive sleep apnea (OSA). MATERIALS and METHODS:This study was prospective and controlled. Adenoids were obtained from children undergoing adenoidectomy for recurrent AOM (n=7) or OSA (n=13). Specimens were processed for total deoxyribonucleic acid (DNA) isolation. 16s DNA 454-pyrosequencing was performed on AOM (n=5) and OSA (n=5) specimens. All specimens were analyzed by real-time polymerase chain reaction for the quantification of the oral commensal bacteria, Streptococcus salivarius. RESULTS:All adenoid specimens had evidence of microbes. Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus were among the dominant species in all samples. S. salivarius, Prevotella sp. and Terrahaemophilus aromaticivorans were more common on adenoids from OSA patients (p<0.05). Bradyrhizobium sp. was more common on adenoids from patients with recurrent AOM (p<0.05). The microbial profiles associated with recurrent AOM were different from, but overlapped with OSA. S. salivarius quantified by real-time PCR was not different between the two groups. CONCLUSION:Microbes are present on all adenoid specimens, though the microbial profile differs between recurrent AOM and OSA. The clinical significance of these differences remains to be determined.

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“…AOM-causing bacteria and thus may not respond as well to xylitol as those with no or only light colonization. 19,20 This hypothesis deserves further study.…”

Section: Figurementioning

confidence: 91%

Xylitol Syrup for the Prevention of Acute Otitis Media

Vernacchio

Corwin²,

Vezina³

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Xylitol given as a gum or syrup 5 times daily has been shown to reduce the incidence of acute otitis media in children, but this dosing schedule is unlikely to be feasible for many families. WHAT THIS STUDY ADDS:A regimen of viscous xylitol syrup in a dose of 5 g 3 times daily was ineffective in preventing recurrences of acute otitis media in otitis-prone children. abstract BACKGROUND: Acute otitis media (AOM) is a common childhood illness and the leading indication for antibiotic prescriptions for US children. Xylitol, a naturally occurring sugar alcohol, can reduce AOM when given 5 times per day as a gum or syrup, but a more convenient dosing regimen is needed for widespread adoption. METHODS:We designed a pragmatic practice-based randomized controlled trial to determine if viscous xylitol solution at a dose of 5 g 3 times per day could reduce the occurrence of clinically diagnosed AOM among otitis-prone children 6 months through 5 years of age. RESULTS:A total of 326 subjects were enrolled, with 160 allocated to xylitol and 166 to placebo. In the primary analysis of time to first clinically diagnosed AOM episode, the hazard ratio for xylitol versus placebo recipients was 0.88 (95% confidence interval [CI] 0.61 to 1.3). In secondary analyses, the incidence of AOM was 0.53 episodes per 90 days in the xylitol group versus 0.59 in the placebo group (difference 0.06; 95% CI -0.25 to 0.13); total antibiotic use was 6.8 days per 90 days in the xylitol group versus 6.4 in the placebo group (difference 0.4; 95% CI -1.8 to 2.7). The lack of effectiveness was not explained by nonadherence to treatment, as the hazard ratio for those taking nearly all assigned xylitol compared with those taking none was 0.93 (95% CI 0.56 to 1.57). CONCLUSIONS:Viscous xylitol solution in a dose of 5 g 3 times per day was ineffective in reducing clinically diagnosed AOM among otitisprone children. Dr Vernacchio conceptualized and designed the study, supervised all aspects of the study implementation, performed the original analysis, reviewed and revised the analysis, and drafted the original manuscript; Drs Corwin and Mitchell conceptualized and designed the study, supervised all aspects of the study implementation, and reviewed and revised the analysis; Mr Vezina conceptualized and designed the study, monitored the randomization procedures, and reviewed and revised the analysis; Dr Pelton conceptualized and designed the study and reviewed and revised the analysis; Dr Feldman conceptualized and designed the study, created the randomization procedures, performed the original analysis, and reviewed and revised the analysis; Dr Coyne-Beasley supervised all aspects of the study implementation at the UNC site; and all authors reviewed and revised the manuscript and approved the final manuscript as submitted.This trial has been registered at www.clinicaltrials.gov (identifier NCT1044030).www.pediatrics.org/cgi

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Biofilm Density in the Pediatric Nasopharynx: Recurrent Acute Otitis Media versus Obstructive Sleep Apnea

Cited by 38 publications

References 19 publications

Association of adenoid hyperplasia and bacterial biofilm formation in children with adenoiditis in Taiwan

Association of adenoid hyperplasia and bacterial biofilm formation in children with adenoiditis in Taiwan

The Adenoid Microbiome in Recurrent Acute Otitis Media and Obstructive Sleep Apnea

Xylitol Syrup for the Prevention of Acute Otitis Media

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