| Title: | Diagnostic Value of Interleukin-6, I Interleukin-18 and C-Reactive Protein in Differentiating Bacterial from Non-Bacterial Acute Otitis Media in Children |
| Full paper | Not Available |
| Abstract: |
The current study was designed to determine the etiology of acute otitis media (AOM) whether bacterial or non-bacterial in 80 patients ( 40 males & 40 females ) 3- 11 years old attending the E.N.T. Out-Patient Clinic of Denim University Hospital, and to assess the usefulness of estimation of serum levels of Interleukin (114-113, I1-6 and C-reactive protein (CRP ) as markers for differentiation between bacterial and non-bacterial AOM in children. The bacterial etiology of AOM was determined by culturing of the middle ear fluid (NICE), obtained by myringotomy technique front the 80 children, on the classic culture media. Quantitative estimation of IL-1B and I1-6, by the commercially available enzyme linked immunosorbent assay (EL1SA) and CRP, by latex agglutination kit ,were done on serum samples collected front the 80 patients and 16 healthy children age and sex matched and enrolled as a control group. It was found that the bacterial etiology of AOM was confirmed in 60 out of 80 children (75 %). Of these60 cases 22(36.6 %) is due to Staphylococcus attretts (Staph. attretts), 18(30 %) Haemophihts influenzae (H. ittffitenzae), 7( 11.6 "A) Streptococcus pyogenes (Strept pyogenes), 6(10.0 '1/0),S'trept. pneumoniae, 4 (6.6 %) Klebsiella pnettmottiae (Neb. pneumoniae), 2( 3.3 % ) Pseudomonas aerughtosa(P. aerughtosa) and only one case is due to Escherichia coli) infection. The results of this study show that IL- 10, IL- 6 and CRP levels are detectable in all cases of AOM either bacterial or non-bacterial as well as in the uninfected control children with a iatistical difference( P =0.95 confidence). Children with bacterial AOM have significantly higher levels of 11-10, 11-6 and CRP than those with non-bacterial AOM i.e the mean level of IL-1 II is 140.92 ± 4.58 pg/ml in bacterial AOM versus 41.50 ± 2.5 pg/ml in non-bacterial AOM (P> 0.95 confidence). The mean level of IL- 6 is 246.98 ± 6.9pg/m1 in bacterial AOM versus 81.00 ± 7.8pg/m1 in non bacterial AOM (P>0.95confidence)and the mean level of CRP is 30.811 1.75mg/dI in bacterial AOM versus 0.90 ± 0.3mg/dI in non-bacterial AOM ( P >0.95 confidence). In bacterial AOM, further analysis of results shows that 1L-113, IL-6 and CRP levels are different in relation to different bacterial species. The mean concentration of 11,18 is found to be higher in cases of H. influenzae followed by Staph. (wrens, Strept pnettmonitte, Strept pyogenes , P. aeruginosa, E. coil and Ale/i. pneummtiae respectively . The mean concentrations of 11,6 and CRP were found to be higher in cases infected with H. influenzae , followed by Strept pnettmoniae , Staph. auretts „Strept. pyogenes , E. coil, P. Aeruginosa and Kleb. pneummtiae respectively. In conclusion, I1-19; I1-6 and CRP are three parameters, each of them can be used in differentiating bacterial from non bacterial AOM in children without tympanocentesis, consequently, the unnecessary use of antibiotics is avoided |