\s=b\Because Haemophilus influenzae is one of the most common pathogens in otitis media with effusion, we have investigated the antibody response in the serum and middle ear effusion (MEE) in nontypable H influenzae\p=n-\inducedexperimental acute otitis media in the chinchilla, using an enzyme-linked immunosorbent assay. During acute otitis media, a reasonable antibody titer was observed: local antibody titers in the MEEs were equal to or greater than those of the serum samples for four of five MEE samples obtained at one week after inoculation. By two weeks, titers in both serum and MEE samples were increased significantly. However, the bacteria persisted in the middle ear cavity, even in the presence of increasing antibody titers, for up to five weeks after infection. The reason for this persistence of the bacteria in the middle ear is unknown. (Arch Otolaryngol Head Neck Surg 1986;112:554-557) TJaemophilus influenzae, in partic--L Jular the nontypable strains, is one of the most common bacteria iso¬ lated from the middle ear effusions (MEEs) of patients with acute or chronic otitis media with effusion (OME).1"3 Our laboratory recently re¬ ported that the nontypable biotype II strain is the most common pathogen associated with cases of chronic OME4 and that nonviable H influenzae or endotoxin from this organism may also be responsible for the induction of OME.56 There is reason to believe that the endotoxin, a cell wall compo¬ nent of gram-negative bacteria, may be responsible for inducing MEEs and pathologic changes in the middle ear, because a large number of MEE sam¬ ples from patients with chronic OME contained an appreciable amount of endotoxin even when the presence of bacteria could not be demonstrated by culture or Gram's stain.7Even though the underlying reason for the biotype II strain's prevalence in chronic OME is poorly understood, one factor could be the poor immunogenicity of this organism. Little infor¬ mation is available regarding the sys¬ temic and local immune responses against nontypable H influenzae dur¬ ing middle ear infection. Work in this area has been hampered because these bacteria appear to be antigenically heterogeneous,8 and the antigens of this organism that confer protection to the host are undefined.9 The pur¬ pose of this study was to investigate the fundamentals of the antibody responses in serum and MEE samples in the chinchilla after challenge with viable nontypable H influenzae (biotype II).
MATERIALS AND METHODS
BacteriaThe H influenzae nontypable isolate (serologically not typable, but belonging to biotype II), originally isolated from a case of otitis media, was obtained from the Ohio Department of Health Laboratories, Columbus. The bacteria were cultured and used as the inoculum, as described previously.-Experimental Design Forty-one healthy chinchillas (310 to 670 g) without evidence of previous or current infection were used in this study. Thirtyfour chinchillas were aseptically inocu¬ lated directly into the left superior bulla with 0.3 mL of bacterial suspensio...