Bacteriology of otitis media with effusion

Abstract

A study was undertaken to evaluate the prevalence and antibiotic susceptibility of bacteria present in the middle ear of patients with otitis media with effusion. Middle ear effusions (MEE), nasopharyngeal and throat swabs were obtained at operation and cultured for aerobic and anaerobic bacteria. Two hundred and fifty-nine effusions were obtained from 152 subjects examined.Haemophilus influenzaewas isolated from 32 (12.3 per cent) effusions.Streptococcus pneumoniaefrom seven (2.7 per cent),Staphylococcus aureusfrom seven (2.7 per cent), Branhamella catarrhalis from one (0.4 per cent)—Group A β haemolytic streptococci from one (0.4 per cent) andStaphylcoccus epidermidisfrom three (1.9 per cent). The occurrence of respiratory pathogens in MEE reflected their prevalence in the upper respiratory tract. Significantly fewer children who had received antibiotics prior to surgery had organisms present in the MEE. Eight and a half per cent ofH. influenzaeand 64 per cent ofB. catarrhaliswere resistant to ampicillin. The present study confirms that bacteria are present in the middle ear in a significant number of patients with otitis media with effusion.

Long-term result of management of otitis media with effusion in patients with post-irradiated nasopharyngeal carcinoma

“…Bacteriology of post-irradiated ear eVusion is rarely studied in the literature. Previous studies had conWrmed that bacteria were present in the middle ear in a signiWcant number of patients with non-irradiation related OME [19,20]. In contrast, most middle ear eVusion from our patients remained sterile.…”

“…Only 15 (17.6%) patients were free of OME, and one patient had a dry perforated eardrum. The resolution rate of OME in patients with pre-irradiated OME was lower than that of patients without pre-irradiated OME (0.71 vs. 19.7%). But there was no signiWcant diVerence in the resolution rates between patients with or without pre-irradiated OME (p = 0.447).…”

Investigation of the Nasopharyngeal Bacterial Flora in Children with Otitis media with Effusion

“…Several investigators [2,[8][9][10][11] have reported that at tacks of OME are due to impaired ventilation of the mid dle ear caused by eustachian tube dysfunction, inflamma tory components and infectious status. These previous studies of the relationship between attacks of OME and the nasopharyngeal bacterial flora suggested that the bac terial flora had some influence on attacks of OME occur ring via the eustachian tube.…”

“…In children with OME, high levels of pathogens, such as H. in fluenzae and S. pneumoniae, were detected and it was considered important to define the relationship between these strains and OME. However, almost all the reports [1][2][3][4] of strains detected in patients with OME were concerned with pathogens and few stud ies involved detailed investigations of the normal flora.…”

“…In previous studies on patients with otitis media with effusion (OME) [1][2][3][4], bacteriological examinations, in particular investigation of pathogenic microbes in the nasopharynges and effusions in the tympanic cavities, were carried out. It was concluded that OME correlated closely with the presence of middle-ear pathogens in the nasopharynx.…”