Nasal microbial composition and chronic otitis media with effusion: A case-control study

Abstract

Objectives Chronic otitis media with effusion (COME) in children can cause prolonged hearing loss, which is associated with an increased risk of learning delays and behavioural problems. Dispersal of bacterial pathogens from the nasal passages to the middle ear is implicated in COME. We sought to determine whether there is an association between nasal microbial composition and COME in children. Methods A case-control study of children aged 3 and 4 years was conducted. Cases undergoing placement of tympanostomy tubes for COME were compared to healthy controls. Nasal swabs were collected and a questionnaire was administered. The V1-3 region of the 16S rRNA gene was amplified, and sequenced on the Illumina MiSeq. Results 73 children with COME had a lower Shannon diversity index than 105 healthy controls (1.62 [.80] versus 1.88 [.84], respectively; P = .046). The nasal microbiota of cases and controls differed in composition using Bray-Curtis dissimilarity (p = 0.002). Children with COME had a higher abundance of otopathogens and lower abundance of commensals including alpha haemolytic Streptococci and Lactococcus . Cluster analysis revealed 4 distinct nasal microbial profiles. Profiles that were Corynebacterium -dominated (aOR 4.18 [95%CI, 1.68–10.39], Streptococcus -dominated (aOR 3.12 [95%CI, 1.08–9.06], or Moraxella -dominated (aOR 4.70 [95%CI, 1.73–12.80] were associated with COME, compared to a more mixed microbial profile when controlling for age, ethnicity, and recent antibiotics use. Conclusions Children with COME have a less diverse nasal microbial composition with a higher abundance of pathogens, compared to healthy children who have a more mixed bacterial profile with a higher abundance of commensals. Further research is required to determine how nasal microbiota may relate to the pathogenesis or maintenance of COME, and whether modification of the nasal microbiota can prevent or treat children at risk of COME.

Nasal microbiota dominated by Moraxella spp. is associated with respiratory health in the elderly population: a case control study

“…Operational taxonomic units (OTUs) with Alloiococcus or Propionibacterium annotation were renamed. Dolosigranulum is known to be misclassified in the GreenGenes database as Alloiococcus [21]. BLAST search confirmed that the representative sequence matched Dolosigranulum in BLAST.…”

Upper Respiratory Tract Microbiome and Otitis Media Intertalk: Lessons from the Literature

“…In particular, Walker et al showed that the nasal microbiome in children with OME is composed of a higher abundance of pathogens, with a lower abundance of commensals as alpha-hemolytic Streptococci and Lactococcus. Moreover, cluster analysis revealed that profiles dominated by Corynebacterium, Streptococcus, or Moraxella were associated with COME, while healthy children had a more mixed bacterial profile with higher abundance of commensals [81].…”

“…Nasopharyngeal microbiome is less diverse in children suffering from OME than in controls, as highlighted by two case-control studies [80,81]. In particular, Walker et al showed that the nasal microbiome in children with OME is composed of a higher abundance of pathogens, with a lower abundance of commensals as alpha-hemolytic Streptococci and Lactococcus.…”

Recent Perspectives on Gene-Microbe Interactions Determining Predisposition to Otitis Media

“…COME shares a similar clinical presentation but with the addition of continuous serous drainage, while CSOM features purulent drainage leaking from a perforated tympanic membrane or ventilation tube (Mittal et al, 2015; Schilder et al, 2016). Chronic OM etiologies tend to be more serious for patients, as frequent and/or persistent dysfunction of the Eustachian tube may lead to significant hearing loss, thereby negatively impacting language acquisition and behavioral development in children (Cripps and Kyd, 2003; Santos-Cortez et al, 2016; Walker et al, 2019).…”

“…The various morphologies and presentations of OM disease [AOM, recurrent AOM (rAOM), CSOM, OME, and/or COM] is about as varied and dynamic as the bacterial, viral, and fungal microorganisms that contribute to OM pathogenesis. However, the research has well-established the link between rAOM and the major otopathogens S. pneumoniae , non-typeable Haemophilus influenza (NTHi), and M. catarrhalis , and these species are consistently found at higher levels of the NP in studies comparing the microbiota of rAOM and COME cases versus healthy controls (Lappan et al, 2018; Walker et al, 2019). Yet the presence of these same organisms, albeit at lower levels, in the controls suggest their potential role as endogenous pathobionts even in the absence of disease.…”