Alloiococcus otitidis in acute otitis media

Leskinen, Kimmo; Hendolin, Panu; Virolainen-Julkunen, Anni; Ylikoski, Jukka; Jero, Jussi

doi:10.1016/j.ijporl.2003.09.005

Cited by 31 publications

(26 citation statements)

References 17 publications

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“…However, previous studies by Hendolin et al showed that A. otitidis was never detected by culture, but it was detected by PCR more frequently than other middle ear pathogens (13,14). Also in other reports in the literature, A. otitidis was frequently detected by PCR, whereas it was never detected by culture (2,18,19). Although it had been unknown whether a PCR product from bacterial DNA represents viable organisms or not, M. G. Rayner et al demonstrated clear evidence that the presence of bacterial DNA suggested the presence of viable, metabolically active, intact organisms even in culture-negative otitis media (22).…”

Section: Discussionmentioning

confidence: 89%

“…These studies and ours suggest that the organism may have already spread with a high prevalence over almost all the world. Although Leskinen et al suggested that A. otitidis may have no clinical significance in AOM itself (19), they also showed that the presence of A. otitidis was associated with a more prolonged course of OME (18). So, the organism may not be associated with the pathology of AOM; however, it may have influence on the condition of OME, which occurs after AOM.…”

Section: Discussionmentioning

confidence: 99%

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High Incidence of Alloiococcus otitidis in Children with Otitis Media, Despite Treatment with Antibiotics

et al. 2006

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Acute otitis media (AOM) and otitis media with effusion (OME) are common diseases in childhood. Alloiococcus otitidis is a newly recognized species of gram-positive bacterium which was recently discovered as a pathogen associated with OME. Although some studies show that A. otitidis is frequently detected in children with OME, no study is available concerning the clinical efficiency of antibiotics against this organism. The prevalence of A. otitidis in 116 middle ear effusion specimens from 36 AOM and 52 OME patients was examined by culture and PCR. In addition, the prevalence of the bacterium was retrospectively investigated in relation to antibiotic use. A. otitidis was detected in 20 (50%) AOM and 47 (61%) OME specimens. The organism was the most frequent bacterium in AOM as well as in OME and was highly detected even in patients who had been treated with antibiotics, such as beta-lactams or erythromycin. The incidence of A. otitidis in our study was higher than that in Western countries, and our results suggest that drug-resistant strains of A. otitidis may be frequently spread in Japanese children. Our study suggests that antibiotics such as beta-lactams or erythromycin may not be sufficiently effective to eliminate this organism. Further investigation is expected to reveal the clinical role of the organism in otitis media.Acute otitis media (AOM) and otitis media with effusion (OME) are common diseases and important otological problems in childhood (3, 4). Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the three major pathogens in AOM as well as in OME (4,20).In 1989, an unknown gram-positive coccus was recovered from middle ear effusions of children with OME (6). This organism was determined to be a new species of bacterium by 16S rRNA analysis and was named Alloiococcus otitis (1); later the name was revised to Alloiococcus otitidis (9). This organism is difficult to detect in middle ear effusions by conventional culture, because it shows slow growth in vitro and could hinder recovery of the organism from clinical specimens (6). On the other hand, by PCR, A. otitidis was detected in about 50% of OME patients, a higher rate than for the three major pathogens (2, 14). These studies suggest that A. otitidis is one of the major pathogens of OME.However, only a limited number of studies of A. otitidis have been conducted, and no clinical study of A. otitidis is available, although a few studies are available concerning the prevalence or the bacteriological character of this organism. Studies concerning the prevalence of A. otitidis in OME have been performed only in Finland (13,14,18) and in the United Kingdom (2). Other than in these two countries, only a few clinical strains of A. otitidis have been isolated in the United States (5, 6), Turkey (16), Spain (8), and Brazil (5). In Asian countries, even the isolation of A. otitidis has not been reported yet. In addition, as regards the detection of A. otitidis in AOM patients, only the study by Leskinen et al. (19) is available...

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

High Incidence of Alloiococcus otitidis in Children with Otitis Media, Despite Treatment with Antibiotics

et al. 2006

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“…M. catarrhalis has also been the predominant pathogen in children with middle ear effusion (28). PCR increases the detection of pathogens compared to conventional culture (29,30). Many of the previous PCR-based studies were carried out by detecting pathogens from MEF samples taken during episodes of non-acute otitis media, e.g., otitis media with effusion, or during tympanostomy tube replacement (22,31).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…One of the previous studies was conducted in Finland (30). Among children in a group with a median age of 30 months and a 25% rate of being otitis prone, M. catarrhalis was the most common pathogen (27%), followed by A. otitidis (25%), S. pneumoniae (20%), and H. influenzae (11%) (30). In a Japanese study by Harimaya et al (23), A. otitidis was detected in 55% of the samples and M. catarrhalis was the next-most-common pathogen (20%).…”

Section: Discussionmentioning

confidence: 99%

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Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

et al. 2016

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f According to studies based on bacterial cultures of middle ear fluids, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis have been the most common pathogens in acute otitis media. However, bacterial culture can be affected by reduced viability or suboptimal growth of bacteria. PCR detects bacterial DNA from samples with greater sensitivity than culture. In the present study, we analyzed the middle ear pathogens with both conventional culture and semiquantitative real-time PCR in 90 middle ear fluid samples obtained from children aged 5 to 42 months during acute otitis media episodes. Samples were tested for the presence of S. pneumoniae, H. influenzae, M. catarrhalis, Alloiococcus otitidis, Staphylococcus aureus, and Pseudomonas aeruginosa. One or more bacterial pathogens were detected in 42 (47%) samples with culture and in 69 (77%) samples with PCR. According to PCR analysis, M. catarrhalis results were positive in 42 (47%) samples, H. influenzae in 30 (33%), S. pneumoniae in 27 (30%), A. otitidis in 6 (6.7%), S. aureus in 5 (5.6%), and P. aeruginosa in 1 (1.1%). Multibacterial etiology was seen in 34 (38%) samples, and M. catarrhalis was detected in most (85%) of those cases. Fifteen signals for M. catarrhalis were strong, suggesting a highly probable etiological role of the pathogen. In conclusion, even though M. catarrhalis is often a part of mixed flora in acute otitis media, a considerable proportion of cases may be primarily attributable to this pathogen. B acterial culture of middle ear fluid (MEF) has been the standard for etiologic diagnosis of acute otitis media (AOM).Streptococcus pneumoniae is considered the most common bacterial pathogen, followed by Haemophilus influenzae and Moraxella catarrhalis (1-3). About 44% to 75% of MEF samples are positive for bacterial pathogens in conventional culture (2, 4). However, the proportions of culture-positive MEF samples decrease in patients with recurrent AOM (5) and in patients with treatment failure (6). Host defense mechanisms and previous antibiotic treatments may directly contribute to diminished survival of the pathogens in clinical samples and diminish the likelihood of detection of bacteria by culture. In addition, the presence of bacterial biofilms has been correlated with negative bacterial cultures (7) and some of the bacterial pathogens, e.g., Alloiococcus otitidis, grow poorly in conventional cultures (8).Virus infections have also been considered causative agents in AOM (2, 9). Preceding or concurrent viral upper respiratory tract infection is typical in AOM (10), and interactions of viruses and bacteria in the nasopharynx may play an important role in the pathogenesis of AOM (10-12). In the era of increasing antimicrobial resistance, precise information concerning MEF pathogens may be beneficial for empirical antibiotic therapy, and therefore PCR technique applied to samples from this primarily sterile site may help to achieve more-accurate bacterial etiologic diagnosis of AOM.Previous studies of AOM in Finnish pop...

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Identification of the Bacterial Reservoirs for the Middle Ear Using Phylogenic Analysis

Chan

Wabnitz

Bassiouni

et al. 2017

JAMA Otolaryngol Head Neck Surg

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Alloiococcus otitidis in acute otitis media

Cited by 31 publications

References 17 publications

High Incidence of Alloiococcus otitidis in Children with Otitis Media, Despite Treatment with Antibiotics

High Incidence of Alloiococcus otitidis in Children with Otitis Media, Despite Treatment with Antibiotics

Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

Identification of the Bacterial Reservoirs for the Middle Ear Using Phylogenic Analysis

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