Résumé
Background: Staphylococcal superantigens [Sag and aposs] may have some role in otitis media with effusion [OME]. The aim of this study was the search of staphylococcal Sag and aposs in middle ear effusion of children with OME
Methods: This cross sectional-analytic study was done in ENT and pediatric wards upon 64 children with otitis media with effusion [OME] between 1-15 years, [mean age=7.42+4 years] of Rasoul Akram University Hospital, Tehran, Iran in 2009-2011. Fifty six percent [36] of cases were male, 43.8% [28] were female. Staphylococcal Sag and aposs Toxic Shock Syndrome Toxin-1 [TSST-1], Staphylococcal enterotoxin A, B, C, D [Enzyme immune assay, AB Cam, USA] were detected in middle ear effusion samples after conventional culture
Results: None type of Sag and aposs found in 39% of OME cases, enterotoxin B found in: 22% enterotoxin A: 17%, enterotoxin C: 15.6%, enterotoxin D: 12.5%, Toxic Shock Syndrome Toxin-1 [TSST-1]: 7.8% Mean age of cases with positive TSST-1, enterotoxin A, B, C, and D was: 1, 5, 8.6, 9.6 and 9.6 years respectively. Positive TSST had no agreement with positive enterotoxin A and C but had weak agreement with type B and D. Mean age of cases with positive TSST was one years which had significant difference with [7.9 years] in cases with negative TSST test [P<0.0001]
Conclusion: At least one or more type of staphylococcal toxins had found in middle ear effusion of 70% of OME cases with negative culture for Staphylococcus aureus. Even in culture negative cases, staphylococcal toxins might have some immunologic role in middle ear effusion forming. Finding the SAgandaposs [at least one type] are important for treatment of immunosuppressive or corticosteroid in cases with resistant OME