Nasopharyngeal colonization of otopathogens in South Indian children with acute otitis media – A case control pilot study

Abstract

Background Acute otitis media (AOM) is an inflammatory disease of the middle ear causing significant morbidity in early childhood. A pilot study was undertaken to identify the role of various risk factors South Indian children with AOM, especially the role of nasopharyngeal otopathogens. Methodology A prospective case control pilot study was conducted in children aged below six years, presenting to a single tertiary care from 2018 to 2019. Fifty cases with AOM and 45 age and gender matched controls were recruited. Two nasopharyngeal swabs were collected, one was processed for bacterial culture. The other swab was processed according to the CDC recommended broth enrichment method to identify carriage of S. pneumoniae. Subsequent serotyping was done by Quellung method and conventional sequential multiplex PCR. Result Otalgia was the major presentation seen in 92% of the children with AOM. None of the clinical and demographic characteristics were found to be statistically significant between the cases and controls. The most common otopathogen was S. pneumoniae (55%) followed by H. influenza (29%). The common S. pneumoniae serotypes encountered were 11A and 19F.Nasopharyngeal colonization with S. pneumoniae [OR 6.57, p < 0.003] and H. influenzae [OR14.18, p < 0.003] were significant risk factors for AOM in children. The risk increased with co-colonization (OR 13.89,p < 0.003). Conclusion This study strengthens the significant association between nasopharyngeal colonization of otopathogens and AOM as a risk factor that is enhanced by co-colonization. S. pneumoniae was the main otopathogen in this population, serotypes 11A and 19F being the most common.

The occurrence of acute otitis media according to nasopharyngeal pathogen detections in acutely ill children

“…There are limitations in the study. Recently, Moraxella catarrhalis has been detected in 6%-20% of AOM cases, 1,3,4 but many multiplex PCR platforms do not include M. catarrhalis in their respiratory tract panels. Thus, a proportion of viral-classified AOM may be M. catarrhalisrelated.…”

“…The development of acute otitis media (AOM) is strongly associated with viral respiratory tract infection followed by a bacterial infection rising from the nasopharynx to the middle ear. There is limited evidence on the association of nasopharyngeal viral and bacterial multiplex polymerase chain reaction (PCR) findings with AOM in clinical practice in acutely ill children 1–4 . We aimed to evaluate the occurrence of AOM according to different nasopharyngeal viral and bacterial detections in real‐life setting using commercial multiplex PCR.…”

“…There is limited evidence on the association of nasopharyngeal viral and bacterial multiplex polymerase chain reaction (PCR) findings with AOM in clinical practice in acutely ill children. [1][2][3][4] We aimed to evaluate the occurrence of AOM according to different nasopharyngeal viral and bacterial detections in real-life setting using commercial multiplex PCR.…”

Nasopharyngeal carriage rates and serotype distribution of Streptococcus pneumoniae among school children with acute otitis media in Central Java, Indonesia

“…Furthermore, serotypes 3, 6A, 6B, 9V, 14, 19A, 19F and 23F are the most common pneumococcal serotypes that cause AOM worldwide [ 10 ]. However, non-vaccine serotypes, such as 11A and 15B/15C, are also known to frequently cause AOM worldwide [ 15 ]. Recently, it was reported that non-PCV13 serotypes (23A and 15B/C) were common in children under 5 years old with otitis media and those without in Taiwan [ 16 ].…”