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. 2023 Oct;107(2):116040.
doi: 10.1016/j.diagmicrobio.2023.116040. Epub 2023 Jul 26.

Reliability of nasopharyngeal PCR for the detection of otopathogens in children with uncomplicated acute otitis media compared to culture

Holly M Frost  1 , Timothy C Jenkins  2 , Thresia Sebastian  3 , Sarah K Parker  4 , Amy Keith  5 , Melanie Kurtz  5 , Dana R Fletcher  6 , Michael L Wilson  7 , Samuel R Dominguez  4
Affiliations

Reliability of nasopharyngeal PCR for the detection of otopathogens in children with uncomplicated acute otitis media compared to culture

Holly M Frost et al. Diagn Microbiol Infect Dis. 2023 Oct.

Abstract

Otopathogens in acute otitis media (AOM) have implications for care because the likelihood of resolution without antibiotics and optimal antibiotic agent varies by microorganism. We aimed to determine the sensitivity, specificity, positive predictive value, and negative predictive value of nasopharyngeal (NP) qualitative polymerase chain reaction (PCR) for common bacterial otopathogens in children with AOM compared to NP culture. NP flocked swabs collected from enrolled children aged 6 to 35 months with uncomplicated AOM in Denver, CO were tested by culture and multiplex PCR. The sensitivity and negative predictive value of PCR using culture as a reference were high (H. influenzae 93.3%, 98.0%; S. pneumoniae 94.2%, 95.1%; M. catarrhalis 92.3%, 86.4%); whereas the specificity and positive predictive value were lower and varied by organism (54.2%-84.1%, 55.1%-69.2%, respectively). PCR detected 1.5 times more organisms than culture. NP PCR has a high predictive value for excluding otopathogens compared to culture and warrants exploration as a diagnostic tool.

Keywords: Acute otitis media; Otopathogens; Pediatrics; Polymerase chain reaction.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: HF serves as a senior scientific advisor for QuidelOrtho and holds a patent for diagnosing and treating otitis media #63/335,801. QuidoOrtho had no role in the design or interpretation of the study and Quidel staff were blinded to culture results. SD serves as a consultant and receives grant support from Biofire, serves as a consultant for Karius, and receives grant support from Pfizer for projects not pertaining to this project.

Figures

Figure 1:
Figure 1:
Number of children for whom organisms were detected by PCR and culture by doses of amoxicillin taken.
Figure 2:
Figure 2:
Proportion of children positive by PCR and culture by doses of amoxicillin taken at enrollment.
See this image and copyright information in PMC

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