Analysis of the mucous microbiome of the nasopharynx in children with chronic adenoiditis and otitis media of effusion

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Abstract

The role of pathology of the adenoid in the development of otitis media of effusion (OME) is currently being discussed. OME is a disease of the middle ear, which is characterized by the accumulation of exudate behind the tympanic membrane in the absence of perforation for three months or longer, leading to hearing loss, increasing the risk of delayed formation of correct speech in the child and behavioral problems. The question of the development of OME, in view of the presence of an infectious focus in the adenoid and further spread to the auditory tube, is ambiguous. In some works, the possible spread of the inflammatory process to the Eustachian tube with long-term preservation of pathogenic microorganisms in the structure of the lymphoid tissue, which is characteristic of persistent viral infections, and the further development of OME are considered. The mucous membrane of the nasopharynx is inhabited by many microorganisms: representatives of an indigenous microbiota, opportunistic and pathogenic.

Aim. To study the microbiome of the mucous membrane of the nasopharynx and middle ear in children with chronic adenoiditis (CA) and OME.

Materials and methods. The study included 174 children with OME and CA (114 boys and 60 girls) aged 3 to 14 years (6.9±0.5 years). We have developed a staged diagnostic algorithm, including the collection of a life history, illness and complaints of the child (or his parents), as well as ENT examination, endoscopy of the nasopharynx, otoendoscopy, audiological examination, microbiological examination by real time PCR, whole genome sequencing NGS.

Results. The main microorganisms of the nasopharyngeal mucosa in children with CA and OME of different age groups are described.

Conclusion. In the treatment of children with CA and OME, it is necessary to take into account the features of the normal microbiota of the nasopharynx; it is important to understand that by acting on opportunistic and pathogenic microorganisms, it is necessary to remember to create favorable conditions for stimulating the growth and development of representatives of the indigenic microbiota, which in turn will contribute to the patient’s speedy recovery and absence of relapses in the future.

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About the authors

Elena P. Karpova

Russian Medical Academy of Continuous Professional Education; Bashlyaeva Children’s City Clinical Hospital

Author for correspondence.
Email: edoctor@mail.ru
ORCID iD: 0000-0002-8292-9635

D. Sci. (Med.), Prof.

Russian Federation, Moscow; Moscow

Aleksandr V. Gurov

Pirogov Russian National Research Medical University; Sverzhevsky Research Clinical Institute of Otorhinolaryngology

Email: Alex9999@inbox.ru

D. Sci. (Med.), Prof.

Russian Federation, Moscow; Moscow

Kseniia Y. Burlakova

Russian Medical Academy of Continuous Professional Education; Bashlyaeva Children’s City Clinical Hospital

Email: ks386@yandex.ru
ORCID iD: 0000-0002-9079-3985

Graduate Student

Russian Federation, Moscow; Moscow

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Supplementary files

Supplementary Files
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1. Fig. 1. Electrophoresis of amplified fragments of 16S rRNA genes of some samples of smears and nasopharynx.

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2. Fig. 2. Electrophoresis of NGS-indexed fragments of 16S rRNA genes of some samples of smears and nasopharynx.

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3. Fig. 3. The degree of hypertrophy of the pharyngeal tonsil according to the results of endoscopic examination of the nasopharynx in children with chronic adenoiditis and exudative otitis media (n=174).

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