tetano
Editor, Senior Moderator
Ther Adv Infect Dis. 2019 Nov 19;6:2049936119871127. doi: 10.1177/2049936119871127. eCollection 2019 Jan-Dec. [h=1]The yield of respiratory viruses detection testing is age-dependent in children with acute otitis media.[/h]
Marom T[SUP]1[/SUP], Fellner A[SUP]2[/SUP], Hirschfeld Z[SUP]2[/SUP], Lazarovitch T[SUP]3[/SUP], Gavriel H[SUP]2[/SUP], Muallem-Kalmovich L[SUP]2[/SUP], Pitaro J[SUP]2[/SUP].
[h=3]Author information[/h] 1 Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, Zerifin, 70300, Israel. 2 Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, Zerifin, Israel. 3 Clinical Microbiology Laboratory, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, Zerifin, Israel.
[h=3]Abstract[/h] [h=4]Background:[/h] Studies of nasopharyngeal secretions serve as reliable surrogate to evaluate the involvement of viruses in acute otitis media (AOM) and upper/lower respiratory tract infections (URIs/LRIs). We explored nasopharyngeal viral studies from children with uncomplicated AOM and examined their cost-effectiveness in relation to their age.
[h=4]Methods:[/h] We identified children aged 0-6 years admitted to our pediatrics department in a university-affiliated, secondary hospital with uncomplicated AOM and concurrent URI/LRI between 2012 and 2017, during October-April, when viral studies are performed. Studies were performed either using antigen detection tests, for respiratory syncytial virus (RSV) and influenza A/B (2012-2016) and for a variety of other common respiratory viruses, utilizing multiplex polymerase chain reaction assays (2017).
[h=4]Results:[/h] A total of 249 children were included (median age: 15 months). In 88 (35%) children, viral studies were positive, most of them in children ⩽24 months (78, 89%). RSV was positive in 52 (59%) children, followed by influenza A and B, in 11 (13%) and 5 (6%) children, respectively. First year switch to a molecular assay, 4.5-fold more expensive, resulted in a statistically significant higher yield: 69% positive results in ⩽24 months, and 66% in those aged ⩽12 months (p < 0.05). In those ⩽24 months, US$23 and US$95 were spent for one positive test in the antigen detection years and the polymerase chain reaction year, respectively, whereas in those >24 months, US$83 and US$878 were invested for one positive test in the same year, respectively.
[h=4]Conclusion:[/h] In cost-effectiveness terms, the greatest benefit of nasopharyngeal studies was highest in children ⩽24 months.
? The Author(s), 2019.
[h=4]KEYWORDS:[/h] acute otitis media; cost-effectiveness; nasopharynx; polymerase chain reaction; respiratory syncytial virus; viruses
PMID: 31798867 PMCID: PMC6868570 DOI: 10.1177/2049936119871127
Free PMC Article
Marom T[SUP]1[/SUP], Fellner A[SUP]2[/SUP], Hirschfeld Z[SUP]2[/SUP], Lazarovitch T[SUP]3[/SUP], Gavriel H[SUP]2[/SUP], Muallem-Kalmovich L[SUP]2[/SUP], Pitaro J[SUP]2[/SUP].
[h=3]Author information[/h] 1 Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, Zerifin, 70300, Israel. 2 Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, Zerifin, Israel. 3 Clinical Microbiology Laboratory, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, Zerifin, Israel.
[h=3]Abstract[/h] [h=4]Background:[/h] Studies of nasopharyngeal secretions serve as reliable surrogate to evaluate the involvement of viruses in acute otitis media (AOM) and upper/lower respiratory tract infections (URIs/LRIs). We explored nasopharyngeal viral studies from children with uncomplicated AOM and examined their cost-effectiveness in relation to their age.
[h=4]Methods:[/h] We identified children aged 0-6 years admitted to our pediatrics department in a university-affiliated, secondary hospital with uncomplicated AOM and concurrent URI/LRI between 2012 and 2017, during October-April, when viral studies are performed. Studies were performed either using antigen detection tests, for respiratory syncytial virus (RSV) and influenza A/B (2012-2016) and for a variety of other common respiratory viruses, utilizing multiplex polymerase chain reaction assays (2017).
[h=4]Results:[/h] A total of 249 children were included (median age: 15 months). In 88 (35%) children, viral studies were positive, most of them in children ⩽24 months (78, 89%). RSV was positive in 52 (59%) children, followed by influenza A and B, in 11 (13%) and 5 (6%) children, respectively. First year switch to a molecular assay, 4.5-fold more expensive, resulted in a statistically significant higher yield: 69% positive results in ⩽24 months, and 66% in those aged ⩽12 months (p < 0.05). In those ⩽24 months, US$23 and US$95 were spent for one positive test in the antigen detection years and the polymerase chain reaction year, respectively, whereas in those >24 months, US$83 and US$878 were invested for one positive test in the same year, respectively.
[h=4]Conclusion:[/h] In cost-effectiveness terms, the greatest benefit of nasopharyngeal studies was highest in children ⩽24 months.
? The Author(s), 2019.
[h=4]KEYWORDS:[/h] acute otitis media; cost-effectiveness; nasopharynx; polymerase chain reaction; respiratory syncytial virus; viruses
PMID: 31798867 PMCID: PMC6868570 DOI: 10.1177/2049936119871127
Free PMC Article