Microbiology of middle ear effusions from 292 patients undergoing tympanostomy tube placement for middle ear disease

We observed a high rate of culture positivity for A. otitidis in patients with clinical OME without suppuration. Further studies are needed to confirm whether the association of A. otitidis with OME represents causality. Antibiotic therapy aimed at A. otitidis is complicated by reported resistance, thus emphasizing the importance of our understanding of the pathogenetic role played by this organism

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“…We observed a high incidence of S. pneumoniae that followed previous H. influenza AOM as observed in other studies (11).…”

Section: Discussionsupporting

confidence: 88%

Serous Otitis Media in Children

Martínez

Macías²

2008

Otology &Amp; Neurotology

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“…Our findings are in agreement with prior evidence in terms of overall percentages of positive cultures and a high percentage of H influenzae and nonpathogenic Staphylococcus, but we found no M catarrhalis, a common organism usually identified in about 10% of middle ear effusions. 21,22 Our low rate of S pneumoniae is in agreement with studies 22,23 that demonstrate lower prevalence since the introduction of the pneumococcal 7-valent conjugate vaccine. Jung et al 24 identified MRSA among 4.1% and MSSA among 3.8% of 289 children undergoing BMT in Seoul, Korea, between 2004 and 2008, a 5-fold higher percentage of S aureus than that obtained in our study.…”

Section: Commentsupporting

confidence: 90%

Methicillin-Resistant <emph type="ital">Staphylococcus aureus</emph> Colonization in Otitis-Prone Children

Marzouk

Nathawad²,

Hammerschlag³

et al. 2011

Arch Otolaryngol Head Neck Surg

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“…As in other studies [3,20,24,25], H. influenzae was the most frequently cultured otopathogen, although we found a higher number of positive cultures for otopathogens in our middle ear samples, compared to other studies, where bacteria were culturable in less than 60 % of OME samples [3,20,24,25]. This could be explained by the younger age of our patients (all between 1 and 6 years old) compared to other studies that also included older children or even adults, where it was found that children appeared to have a greater number of culture positive MEEs compared to adults with COME [3,24,25]. Also, our strict exclusion of patients that used topical (nose and/or ear) or systemic antibiotics within 30 days before the sample collection could explain our higher rate of culture positive middle ear samples compared to studies that did not exclude antibiotic usage prior to MEE sampling [24,25].…”

Section: Discussionsupporting

confidence: 79%

Haemophilus influenzae biofilm formation in chronic otitis media with effusion

Hoecke

Paepe

Lambert

et al. 2016

Eur Arch Otorhinolaryngol

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Otitis media with effusion (OME) is a highly prevalent disease in children, but the exact pathogenesis and role of bacteria are still not well understood. This study aimed to investigate the presence of otopathogenic bacteria in the middle ear effusion (MEE) and adenoid of children with chronic OME (COME), and to investigate in vivo whether these bacteria, especially Haemophilus influenzae, are organized as a biofilm in the middle ear fluid. MEE and adenoid samples were collected from 21 patients with COME. Extensive bacterial culturing and genotyping was performed on all middle ear and adenoid samples. Fluorescence in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM) was used to visualize possible biofilm structures for a selection of middle ear effusion samples. 34 MEE samples were collected from 21 patients of which 64.7 % were culture positive for bacteria and 47.0 % were culture positive for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and/or Streptococcus pneumoniae. All 21 adenoid samples were culture positive for one or more of these four otopathogens. H. influenzae (35.3 %) and S. pneumoniae (76.2 %) were the most frequently cultured bacteria in the MEE and adenoid samples, respectively. The same bacterial species was found in MEE and adenoid for 84.6 % of the patients and in 81.2 % of the cases where the same species was found in more than one site it involved the same bacterial genotype. FISH and CLSM demonstrated the presence of H. influenzae specific biofilm structures in five of the eight culture positive MEEs that were tested, but in none of the two culture negative MEEs. The findings in this study indicate that the adenoid acts as a reservoir for bacteria in MEE and confirms that biofilms, in at least half of the cases consisting of H. influenzae, are indeed present in the MEE of children with COME. Biofilms may thus play a crucial role in the pathogenesis of COME, which is important in the understanding of this disease and the development of potential future treatment options.

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Microbiology of middle ear effusions from 292 patients undergoing tympanostomy tube placement for middle ear disease

Cited by 37 publications

References 11 publications

Serous Otitis Media in Children

Serous Otitis Media in Children

Methicillin-Resistant <emph type="ital">Staphylococcus aureus</emph> Colonization in Otitis-Prone Children

Haemophilus influenzae biofilm formation in chronic otitis media with effusion

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