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

Cover Page

Cite item

Full Text

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.

Full Text

Restricted Access

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

References

  1. Ивашкин В.Т., Ивашкин К.В. Микробиом человека в приложении к клинической практике. Рос. журн. гастроэнтерологии, гепатологии, колопроктологии. 2017; 27 (6): 4–13 [Ivashkin VT, Ivashkin KV. Mikrobiom cheloveka v prilozhenii k klinicheskoi praktike. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2017; 27 (6): 4–13 (in Russian)].
  2. Плоскирева А.А. У каждого штамма свой эффект, или Предназначение пробиотиков. Участковый педиатр. 2018; 2: 16–7 [Ploskireva AA. U kazhdogo shtamma svoi effekt, ili Prednaznachenie probiotikov. Uchastkovyi pediatr. 2018; 2: 16–7 (in Russian)].
  3. Булатова Е.М., Богданова Н.М. Значение кишечной микробиоты и пробиотиков для формирования иммунного ответа и здоровья ребенка. Вопр. соврем. педиатрии. 2010; 6: 37–44 [Bulatova EM, Bogdanova NM. The value of the intestinal microbiota and probiotics to generate an immune response and child health. Voprosy sovremennoj pediatrii. 2010; 6: 37–44 (in Russian)].
  4. Бондаренко В.П. Микрофлора человека: норма и патология. Наука в России. 2007; 1: 28–35 [Bondarenko V.P. The microflora of the human: health and disease. Nauka v Rossii. 2007; 1: 28–35 (in Russian)].
  5. Быкова В.П. Новые аргументы в поддержку органосохраняющего направления при лечении аденоидов у детей. Дет. оториноларингология. 2013; 2: 18–22 [Bykova VP. New arguments in support of organpreserving directions in the treatment of adenoids in children. Det. otorinolaringologija. 2013; 2: 18–22 (in Russian)].
  6. Извин А.И., Катаева Л.В. Микробный пейзаж слизистой оболочки верхних дыхательных путей в норме и патологии. Вестн. оториноларингологии. 2009; 2: 65–8 [Izvin AI, Kataeva LV. Microbial landscape of the mucous membrane of the upper respiratory tract in health and disease. Vestn. otorinolaringologii. 2009; 2: 65–8 (in Russian)].
  7. Рощектаева Ю.А. Клинико-эпидемиологические характеристики экссудативного среднего отита у детей. Вестн. оториноларингологии. 2014; 6: 43–6 [Roshchektaeva IA. The clinical and epidemiological characteristics of exudative otitis media in the child population. Vestn. otorinolaringologii. 2014; 6: 43–6 (in Russian)]. doi: 10.17116/otorino2014643-46
  8. Buzatto GP, Tamashiro E, Saturno TH, Prates MC. The pathogens profile in children with otitis media with effusion and adenoid hypertrophy. PLoS One 2017; 12 (2). doi: 10.1371/journal.pone.0171049
  9. De Miguel Martinez I, Ramos Maclas A, et al. Bacterial implication in otitis media with effusion in childhood. Acta Otorrinolaringol Esp 2007; 58 (9): 408–12.
  10. Ragland SA, Criss AK. From bacterial killing to immune modulation: Recent insights into the function of lysozyme. PloS Pathog 2017; 13 (9). doi: 10.1371/journal.ppat.1006512
  11. Ngo CC, Massa HM, Thornton RB, Cripps AW. Predominant bacteria detected from the middle ear fluid of children experiencing otitis media: a systematic review. PLoS One 2016; 11: e0150949. PMID: 26953891
  12. Карпова Е.П., Тулупов Д.А. О роли различных этиологических факторов в развитии хронической патологии носоглотки у детей. Лечащий врач. 2013; 1: 12–4 [Karpova EP, Tulupov DA. On the role of various etiological factors in the development of chronic nasopharyngeal pathology in children. Lechachiy vrach. 2013; 1: 12–4 (in Russian)].
  13. Stol K, Verhaegh SJ, Graamans K, et al. Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion. Int J Pediatr Otorhinolaryngol 2013; 77 (4): 488–93.
  14. Liu CM, Cosetti MK, Aziz M, et al. The otologic microbiome: a study of the bacterial microbiota in a pediatric patient with chronic serous otitis media using 16SrRNA gene-based pyrosequencing. Arch Otolaryngol Head Neck Surg 2011; 137: 664–8.
  15. Jervis-Bardy J, Rogers GB, Morris PS, et al. The microbiome of otitis media with effusion in Indigenous Australian children. Int J Pediatr Otorhinolaryngol 2015; 79: 1548–55.
  16. Brook I, Shah K, Jackson W. Microbiology of healthy and diseased adenoids. Laryngoscope 2000; 110 (6): 994–9. doi: 10.1097/00005537-200006000-00021
  17. Marsh RL, Aho C, Beissbarth J, et al. Panel 4: Recent advances in understanding the natural history of the otitis media microbiome and its response to environmental pressures. Int J Pediatr Otorhinolaryngol 2020; 130: 109836. doi: 10.1016/j.ijporl.2019.109836
  18. Kim SK, Hong SJ, Pak KH, et al. Analysis of the Microbiome in the Adenoids of Korean Children with Otitis Media with Effusion. J Int Adv Otol 2019; 15 (3): 379–85. doi: 10.5152/iao.2019.6650
  19. Xu J, Dai W, Liang Q, Ren D. The microbiomes of adenoid and middle ear in children with otitis media with effusion and hypertrophy from a tertiary hospital in China. Int J Pediatr Otorhinolaryngol 2020; 134: 110058. doi: 10.1016/j.ijporl.2020.110058.

Supplementary files

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

Download (91KB)
3. Fig. 2. Electrophoresis of NGS-indexed fragments of 16S rRNA genes of some samples of smears and nasopharynx.

Download (73KB)
4. 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).

Download (82KB)

Copyright (c) 2021 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies