Persistent acute otitis media

Pichichero, Michael E.; Pichichero, Christy

doi:10.1097/00006454-199503000-00002

Cited by 110 publications

(52 citation statements)

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“…About 44% to 75% of MEF samples are positive for bacterial pathogens in conventional culture (2,4). However, the proportions of culture-positive MEF samples decrease in patients with recurrent AOM (5) and in patients with treatment failure (6). Host defense mechanisms and previous antibiotic treatments may directly contribute to diminished survival of the pathogens in clinical samples and diminish the likelihood of detection of bacteria by culture.…”

Section: B Acterial Culture Of Middle Ear Fluid (Mef) Has Been the Stmentioning

confidence: 99%

Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

et al. 2016

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f According to studies based on bacterial cultures of middle ear fluids, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis have been the most common pathogens in acute otitis media. However, bacterial culture can be affected by reduced viability or suboptimal growth of bacteria. PCR detects bacterial DNA from samples with greater sensitivity than culture. In the present study, we analyzed the middle ear pathogens with both conventional culture and semiquantitative real-time PCR in 90 middle ear fluid samples obtained from children aged 5 to 42 months during acute otitis media episodes. Samples were tested for the presence of S. pneumoniae, H. influenzae, M. catarrhalis, Alloiococcus otitidis, Staphylococcus aureus, and Pseudomonas aeruginosa. One or more bacterial pathogens were detected in 42 (47%) samples with culture and in 69 (77%) samples with PCR. According to PCR analysis, M. catarrhalis results were positive in 42 (47%) samples, H. influenzae in 30 (33%), S. pneumoniae in 27 (30%), A. otitidis in 6 (6.7%), S. aureus in 5 (5.6%), and P. aeruginosa in 1 (1.1%). Multibacterial etiology was seen in 34 (38%) samples, and M. catarrhalis was detected in most (85%) of those cases. Fifteen signals for M. catarrhalis were strong, suggesting a highly probable etiological role of the pathogen. In conclusion, even though M. catarrhalis is often a part of mixed flora in acute otitis media, a considerable proportion of cases may be primarily attributable to this pathogen. B acterial culture of middle ear fluid (MEF) has been the standard for etiologic diagnosis of acute otitis media (AOM).Streptococcus pneumoniae is considered the most common bacterial pathogen, followed by Haemophilus influenzae and Moraxella catarrhalis (1-3). About 44% to 75% of MEF samples are positive for bacterial pathogens in conventional culture (2, 4). However, the proportions of culture-positive MEF samples decrease in patients with recurrent AOM (5) and in patients with treatment failure (6). Host defense mechanisms and previous antibiotic treatments may directly contribute to diminished survival of the pathogens in clinical samples and diminish the likelihood of detection of bacteria by culture. In addition, the presence of bacterial biofilms has been correlated with negative bacterial cultures (7) and some of the bacterial pathogens, e.g., Alloiococcus otitidis, grow poorly in conventional cultures (8).Virus infections have also been considered causative agents in AOM (2, 9). Preceding or concurrent viral upper respiratory tract infection is typical in AOM (10), and interactions of viruses and bacteria in the nasopharynx may play an important role in the pathogenesis of AOM (10-12). In the era of increasing antimicrobial resistance, precise information concerning MEF pathogens may be beneficial for empirical antibiotic therapy, and therefore PCR technique applied to samples from this primarily sterile site may help to achieve more-accurate bacterial etiologic diagnosis of AOM.Previous studies of AOM in Finnish pop...

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Section: B Acterial Culture Of Middle Ear Fluid (Mef) Has Been the Stmentioning

confidence: 99%

Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

et al. 2016

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“…Although there is an up to 60 to 80% spontaneous cure rate for AOM at late follow-up (11), AOM due to Streptococcus pneumoniae is less likely to resolve without antibiotics (4,13). S. pneumoniae is also the most common pathogen isolated in middle ear fluid from patients who have failed antibiotic therapy (10). These findings underscore the need for a stepwise approach to treatment of AOM aimed at documenting inflammation as it relates to acute infection, and they attempt to identify specific pathogens.…”

mentioning

confidence: 99%

Systemic Inflammatory Responses in Children with Acute Otitis Media Due toStreptococcus pneumoniaeand the Impact of Treatment with Clarithromycin

Scharer

Zaldivar

González

et al. 2003

Clin Vaccine Immunol

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This pilot study was designed to determine the serum cytokine profile of acute otitis media (AOM) due to Streptococcus pneumoniae and the impact of clarithromycin (Abbott Laboratories, Inc). Serum levels of interleukin-1␤ (IL-1␤), tumor necrosis factor alpha (TNF-␣), IL-6, and IL-8 were measured at diagnosis and 3 to 5 days after start of antibiotic treatment in 10 patients (mean age, 18.3 ؎ 13.9 months) who had middle ear fluid culture positive for S. pneumoniae. The mean concentrations of all cytokines were elevated at diagnosis of AOM compared to levels in healthy controls, yet only IL-6 reached statistical significance (P ‫؍‬ 0.05). IL-6 showed a statistically significant decrease in mean serum concentration at visit 2 (P ‫؍‬ 0.03). IL-8 displayed a similar pattern to IL-6, but the difference between samples from day 1 and day 2 did not reach statistical significance. The cytokines IL-1␤ and TNF-␣ appear to be elevated in the serum of patients with S. pneumoniae AOM, but there was no significant change between mean serum levels obtained pre-and postinitiation of antibiotic treatment in the time frame studied. The results suggest a systemic inflammatory response as evidenced by increased IL-6. A significant decrease of IL-6 and improvement of clinical symptoms were observed. Determining cytokine levels, especially IL-6, in AOM could offer a powerful tool for objective assessment of response to treatment, minimizing unnecessary treatment of asymptomatic children who may still have some otoscopic findings suggestive of AOM at follow-up visits.

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“…catarrhalis se ha identificado principalmente asociado a tres condiciones clínicas: otitis media en niños, así como neumonía y bronquitis en adultos con enfermedad pulmonar crónica y sinusitis. 4,5,7,8 La colonización durante la infancia es un fenó-meno frecuente, sobre todo en menores de dos años. 13 La prevalencia de colonización que se encontró en los niños del Distrito Federal fue similar a los porcentajes notificados en niños de otros países de Europa y Asia y en Estados Unidos de América, 8,14,15 existiendo un predominio en los menores de tres años.…”

Section: Discussionunclassified

“…En los últimos veinte años se ha identificado como germen causal en una diversidad de procesos infecciosos como otitis media, sinusitis, conjuntivitis, bronconeumonía, tos persistente, laringitis y queratitis. [4][5][6][7][8][9] Asimismo, se ha identificado en otitis media en el tercer lugar de los agentes aislados. 10,11 Además, puede dar lugar a enfermedades sistémicas como bacteremia, sepsis, endocarditis, meningitis e infección urinaria complicada en pacientes con enfermedad neoplásica, con enfermedad pulmonar crónica y en aquellos con alteraciones del sistema inmunológico.…”

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Prevalencia de colonización por Moraxella catarrhalis en portadores asintomáticos menores de seis años

Leaños-Miranda¹,

Miranda-Novales²,

Solórzano-Santos³

et al. 2001

Salud pública Méx

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Persistent acute otitis media

Cited by 110 publications

References 0 publications

Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children

Systemic Inflammatory Responses in Children with Acute Otitis Media Due toStreptococcus pneumoniaeand the Impact of Treatment with Clarithromycin

Prevalencia de colonización por Moraxella catarrhalis en portadores asintomáticos menores de seis años

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