Predominant Bacterial and Viral Otopathogens Identified Within the Respiratory Tract and Middle Ear of Urban Australian Children Experiencing Otitis Media Are Diversely Distributed

Abstract

BackgroundOtitis media (OM) is one of the most common infections in young children, arising from bacterial and/or viral infection of the middle ear. Globally, Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the predominant bacterial otopathogens. Importantly, common upper respiratory viruses are increasingly recognized contributors to the polymicrobial pathogenesis of OM. This study aimed to identify predominant bacteria and viruses in the nasopharynx, adenoids and middle ears of peri-urban/urban South-East Queensland Australian children, with and without clinical history of chronic otitis media with effusion (COME) and/or recurrent acute otitis media (RAOM).MethodsSixty children, 43 diagnosed with OM and 17 controls with no clinical history of OM from peri-urban/urban South-East Queensland community were recruited to the study. Respiratory tract bacterial and viral presence were examined within nasopharyngeal swabs (NPS), middle ear effusions (MEE) and adenoids, using real-time polymerase chain reaction (RT-PCR) and bacterial culture.ResultsAt least one otopathogen present was observed in all adenoid samples, 86.1% and 82.4% of NPS for children with and without OM, respectively, and 47.1% of the MEE from the children with OM. NTHi was the most commonly detected bacteria in both the OM and control cohorts within the adenoids (90.0% vs 93.8%), nasopharynx (67.4% vs 58.8%) respectively, and in the MEE (OM cohort 25.9%). Viruses were detected in all adenoid samples, 67.4% vs 47.1% of the NPS from the OM and control cohorts, respectively, and 37% of the MEE. Rhinovirus was the predominant virus identified in the adenoids (85.0% vs 68.8%) and nasopharynx (37.2% vs 41.2%) from the OM and control cohorts, respectively, and the MEE (19.8%).ConclusionsNTHi and rhinovirus are predominant otopathogens within the upper respiratory tract of children with and without OM from peri-urban and urban South-East Queensland, Australia. The presence of bacterial otopathogens within the middle ear is more predictive of concurrent URT infection than was observed for viruses, and the high otopathogen carriage within adenoid tissues confirms the complex polymicrobial environment in children, regardless of OM history.

Identification of the Viral Pathogens in School Children With Acute Otitis Media in Central Java, Indonesia

“… 2 It was recently reported that non-typeable Haemophilus influenzae and rhinovirus were common bacterial and virus pathogens within the upper respiratory tract of peri-urban/urban South-East Queensland Australian children with and without otitis media. 6 Previously, we have reported that 73% and 69.7% of S. pneumoniae and H. influenzae were identified among school children with AOM in Banyumas Regency, Central Java, Indonesia respectively. 7 , 8 Data on the spectrum of viruses that cause AOM in Indonesia are still limited.…”

The role of non-typable Haemophilus influenza in recurrent otitis media in children

“…Specifically, AOM induced by NTHi has been associated with recurrence. In about one-third of instances, recurrent chronic AOM might increase the likelihood of developing chronic suppurative otitis media (CSOM) [3].…”

“…Encapsulated strains are divided into six serotypes (A to F), sharing relative similarity irrespective of their serotype. Conversely, non-encapsulated strains exhibit genetic diversity [3].…”

Otitis media: recent advances in otitis media vaccine development and model systems

“…Contribution to disease by each pathogen varies by study and detection method [see ( Tamir et al, 2023 ] for review of recent reports of microbiology of OM). The viruses that are commonly associated with OM include respiratory syncytial virus (RSV), coronaviruses, influenza viruses, adenoviruses, human metapneumovirus, human bocavirus, and picornaviruses ( Pettigrew et al, 2011 ; Ngo et al, 2022 ). The most commonly associated pathogens with CSOM are Staphylococcus aureus and Pseudomonas aeruginosa ( Afolabi et al, 2012 ; Khattak et al, 2017 ).…”