BACKGROUND: Acute bacterial sinusitis (ABS) is a common complication of viral upper respiratory tract infections (URI). Clinical characteristics of URIs complicated by ABS in young children have not been well studied. METHODS: We identified ABS episodes in a prospective, longitudinal cohort study of 294 children (6-35 months of age at enrollment), who were followed up for 1 year to capture all URI episodes and complications. At the initial URI visit seen by the study personnel (median day = 4 from symptoms onset), nasopharyngeal samples were obtained for bacterial cultures and viral studies. RESULTS: Of 1295 documented URI episodes, 103 (8%) episodes (in 73 children) were complicated by ABS, 32 of which were concurrent with acute otitis media. The majority (72%) of ABS episodes were diagnosed based on persistent symptoms or a biphasic course. Average age at ABS diagnosis was 18.8 ± 7.2 months; White children were more likely to have ABS episodes than Blacks (P = 0.01). Hispanic/Latino ethnicity (P < 0.0001) was negatively associated, and adequate 7-valent pneumococcal conjugate vaccine immunization status (P = 0.001) appeared to increase the risk of ABS. Girls had more ABS episodes than boys (0.5 ± 0.8 vs. 0.3 ± 0.6 episodes/yr, respectively, P = 0.03). Viruses were detected in 63% during the initial URI visit; rhinovirus detection was positively correlated with ABS risk (P = 0.01). Bacterial cultures were positive in 82/83 (99%) available samples obtained at the initial URI visit; polymicrobial (56%), Moraxella catarrhalis (20%) and Streptococcus pneumoniae (10%) were the most common cultures. Presence of pathogenic bacteria overall and presence of M. catarrhalis during URI were positively correlated with the risk for ABS (P = 0.04 for both). CONCLUSIONS: ABS complicates 8% of URI in young children. Girls have more frequent ABS episodes than boys. Presence of rhinovirus and M. catarrhalis during URI are positively correlated with the risk for ABS complication.
BACKGROUND: Acute bacterial sinusitis (ABS) is a common complication of viral upper respiratory tract infections (URI). Clinical characteristics of URIs complicated by ABS in young children have not been well studied. METHODS: We identified ABS episodes in a prospective, longitudinal cohort study of 294 children (6-35 months of age at enrollment), who were followed up for 1 year to capture all URI episodes and complications. At the initial URI visit seen by the study personnel (median day = 4 from symptoms onset), nasopharyngeal samples were obtained for bacterial cultures and viral studies. RESULTS: Of 1295 documented URI episodes, 103 (8%) episodes (in 73 children) were complicated by ABS, 32 of which were concurrent with acute otitis media. The majority (72%) of ABS episodes were diagnosed based on persistent symptoms or a biphasic course. Average age at ABS diagnosis was 18.8 ± 7.2 months; White children were more likely to have ABS episodes than Blacks (P = 0.01). Hispanic/Latino ethnicity (P < 0.0001) was negatively associated, and adequate 7-valent pneumococcal conjugate vaccine immunization status (P = 0.001) appeared to increase the risk of ABS. Girls had more ABS episodes than boys (0.5 ± 0.8 vs. 0.3 ± 0.6 episodes/yr, respectively, P = 0.03). Viruses were detected in 63% during the initial URI visit; rhinovirus detection was positively correlated with ABS risk (P = 0.01). Bacterial cultures were positive in 82/83 (99%) available samples obtained at the initial URI visit; polymicrobial (56%), Moraxella catarrhalis (20%) and Streptococcus pneumoniae (10%) were the most common cultures. Presence of pathogenic bacteria overall and presence of M. catarrhalis during URI were positively correlated with the risk for ABS (P = 0.04 for both). CONCLUSIONS:ABS complicates 8% of URI in young children. Girls have more frequent ABS episodes than boys. Presence of rhinovirus and M. catarrhalis during URI are positively correlated with the risk for ABS complication.
Authors: Elske J M van Gils; Reinier H Veenhoven; Gerwin D Rodenburg; Eelko Hak; Elisabeth A M Sanders Journal: Vaccine Date: 2011-09-03 Impact factor: 3.641
Authors: Eugene H Chang; Debra A Stern; Amanda L Willis; Stefano Guerra; Anne L Wright; Fernando D Martinez Journal: J Allergy Clin Immunol Date: 2018-02-21 Impact factor: 10.793
Authors: Tasnee Chonmaitree; Rocio Trujillo; Kristofer Jennings; Pedro Alvarez-Fernandez; Janak A Patel; Michael J Loeffelholz; Johanna Nokso-Koivisto; Reuben Matalon; Richard B Pyles; Aaron L Miller; David P McCormick Journal: Pediatrics Date: 2016-03-28 Impact factor: 7.124
Authors: Tasnee Chonmaitree; Pedro Alvarez-Fernandez; Kristofer Jennings; Rocio Trujillo; Tal Marom; Michael J Loeffelholz; Aaron L Miller; David P McCormick; Janak A Patel; Richard B Pyles Journal: Clin Infect Dis Date: 2014-09-09 Impact factor: 9.079