Prospective observational case series evaluating middle ear fluid and tympanostomy tubes through pyrosequencing

Wang, James C.; Pillutla, Pranati; Cordero, Joehassin; Hamood, Abdul N.

doi:10.1016/j.ijporl.2018.08.035

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…Similar to anaerobic infections of the sinuses and head and neck tissues, the presence of Porphyromonas or Fusobacterium is likely due to seeding of necrotic or damaged tissue by anaerobic bacterial pathogens after failure of antibiotic treatment ( Brook, 2011 ). These anaerobes may also facilitate biofilm formation ( Wang et al., 2018 ). Identification of these bacteria in cholesteatoma samples that may not be reached by and/or are resistant to the usual otic drops suggest an important opportunity to administer intravenous or oral antibiotics with proper bacterial coverage (e.g., clindamycin, metronidazole, chloramphenicol) immediately after cholesteatoma removal.…”

Section: Discussionmentioning

confidence: 99%

Microbiota Associated With Cholesteatoma Tissue in Chronic Suppurative Otitis Media

Frank

Magno

Velasco

et al. 2022

Front. Cell. Infect. Microbiol.

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Otitis media (OM), defined as infection or inflammation of the middle ear (ME), remains a major public health problem worldwide. Cholesteatoma is a non-cancerous, cyst-like lesion in the ME that may be acquired due to chronic OM and cause disabling complications. Surgery is required for treatment, with high rates of recurrence. Current antibiotic treatments have been largely targeted to previous culturable bacteria, which may lead to antibiotic resistance or treatment failures. For this study, our goal was to determine the microbiota of cholesteatoma tissue in comparison with other ME tissues in patients with long-standing chronic OM. ME samples including cholesteatoma, granulation tissue, ME mucosa and discharge were collected from patients undergoing tympanomastoidectomy surgery for chronic OM. Bacteria were profiled by 16S rRNA gene sequencing in 103 ME samples from 53 patients. Respiratory viruses were also screened in 115 specimens from 45 patients. Differences in bacterial profiles (beta-diversity) and the relative abundances of individual taxa were observed between cholesteatoma and ME sample-types. Additionally, patient age was associated with differences in overall microbiota composition while numerous individual taxa were differentially abundant across age quartiles. No viruses were identified in screened ME samples. Biodiversity was moderately lower in cholesteatoma and ME discharge compared to ME mucosal tissues. We also present overall bacterial profiles of ME tissues by sample-type, age, cholesteatoma diagnosis and quinolone use, including prevalent bacterial taxa. Our findings will be useful for fine-tuning treatment protocols for cholesteatoma and chronic OM in settings with limited health care resources.

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Section: Discussionmentioning

confidence: 99%

Microbiota Associated With Cholesteatoma Tissue in Chronic Suppurative Otitis Media

Frank

Magno

Velasco

et al. 2022

Front. Cell. Infect. Microbiol.

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“…Thus, care must be taken when comparing data from studies that targeted different regions of the 16S rRNA gene. To date, the V1-3 [7,17], V3-4 [4,9,18], V4 [2,11,19,20] and V5-6 [21] regions have all been used in OM studies. A further limitation is that short-read 16S rRNA gene sequences may only provide sufficient taxonomic resolution for bacterial identification to the family or genus-level.…”

Section: Important Limits In the Recent Om Microbiome Literaturementioning

confidence: 99%

“…Failure to address this issue can lead to false conclusions, as recently reported in placental microbiome studies [26]. Despite the risk, bacterial load is often not reported in OM microbiome studies [2,4,5,9,17,19,20]. Among studies that have considered bacterial load limitations, there is heterogeneity in the quantification methods; inclusion, sequencing and reporting of negative controls; and the analytic methods used to identify potential contaminants [7,9,11,18,21].…”

Section: Important Limits In the Recent Om Microbiome Literaturementioning

confidence: 99%

Panel 4: Recent advances in understanding the natural history of the otitis media microbiome and its response to environmental pressures

Marsh

Aho

Beissbarth

et al. 2020

International Journal of Pediatric Otorhinolaryngology

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“…This variability is explained by the differences in study design and time from beginning of symptoms to time of swabbing and method of culture processing (standard cultures, polymerase chain reaction or DNA pyrosequencing analysis). 8 Studies using conventional microbiological cultures showed that Haemophilus influenzae , Staphylococcus aureus , and Pseudomonas aeruginosa were the most common microorganisms isolated in untreated, uncomplicated PTTO cases. Because S aureus and P aeruginosa are normal inhabitants of external auditory canal, their detection in samples from this site does not imply a pathogenic role.…”

Section: Introductionmentioning

confidence: 99%

Role of Biofilms in Post-Tympanostomy Tube Otorrhea

Marom¹,

Habashi²,

Cohen

et al. 2020

Ear Nose Throat J

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Objective: Nearly half of children who undergo tympanostomy tube (TT) insertion may experience otorrhea following surgery. We sought to review the evidence for the role of bacterial biofilms in post-tympanostomy tube otorrhea (PTTO) and the accumulated experience regarding the preventive measures for biofilm formation/adhesion on TTs. Methods: English literature search for relevant MeSH keywords was conducted in the following databases: MEDLINE (via PubMed), Ovid Medline, Google Scholar, and Clinical Evidence (BMJ Publishing) between January 1, 1995, and December 31, 2019. Subsequently, articles were reviewed and included if biofilm was evident in PTTO. Results: There is an increased evidence supporting the role of biofilms in PTTO. Studies on TT design and material suggest that nitinol and/or silicone TTs had a lower risk for PTTO and that biofilms appeared in specific areas, such as the perpendicular junction of the T-tubes and the round rims of the Paparella-type tubes. Biofilm-component DNAB-II protein family was present in half of children with PTTO, and targeting this protein may lead to biofilm collapse and serve as a potential strategy for PTTO treatment. Novel approaches for the prevention of biofilm-associated PTTO include changing the inherent tube composition; tube coating with antibiotics, polymers, plant extracts, or other biofilm-resistant materials; impregnation with antimicrobial compounds; and surface alterations by ion-bombardment or surface ionization, which are still under laboratory investigation. Conclusions: Currently, there is no type of TT on which bacteria will not adhere. The challenges of treating PTTO indicate the need for further research in optimization of TT design, composition, and coating.

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Prospective observational case series evaluating middle ear fluid and tympanostomy tubes through pyrosequencing

Cited by 3 publications

References 20 publications

Microbiota Associated With Cholesteatoma Tissue in Chronic Suppurative Otitis Media

Microbiota Associated With Cholesteatoma Tissue in Chronic Suppurative Otitis Media

Panel 4: Recent advances in understanding the natural history of the otitis media microbiome and its response to environmental pressures

Role of Biofilms in Post-Tympanostomy Tube Otorrhea

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