The Formation of Biofilm and Bacteriology in Otitis Media with Effusion in Children: A Prospective Cross-Sectional Study

Abstract

Background: Otitis media with effusion (OME) can cause serious complications such as hearing impairment or development delays. The aim of the study was to assess the microbiological profile of organisms responsible for OME and to determine if a biofilm formation can be observed. Methods: Ninety-nine samples from 76 patients aged from 6 months to 12 years were collected for microbiological and molecular studies. Results: In microbiological studies, pathogenic bacteria Haemophilus influenzae (38.89%), Streptococcus pneumoniae (33.33%), and Staphylococcus aureus MSSA (27.78%), as well as opportunistic bacteria Staphylococcus spp. (74.14%), Diphtheroids (20.69%), Streptococcus viridans (3.45%), and Neisseria spp. (1.72%) were found. The average degree of hearing loss in the group of children with positive bacterial culture was 35.9 dB, while in the group with negative bacterial culture it was 25.9 dB (p = 0.0008). The type of cultured bacteria had a significant impact on the degree of hearing impairment in children (p = 0.0192). In total, 37.5% of Staphylococcus spp. strains were able to form biofilm. Conclusions: Staphylococcus spp. in OME may form biofilms, which can explain the chronic character of the disease. Pathogenic and opportunistic bacteria may be involved in the etiopathogenesis of OME. The degree of hearing loss was significantly higher in patients from which the positive bacterial cultures were obtained.

Identification of the Bacterial Pathogens in Children with Otitis Media: A Study in the Northwestern Portuguese District of Braga

“…Most of the samples analyzed are from OME cases (85.71%). Therefore, the identification of H. influenzae as the most prevalent pathogen in the MEF agrees with other studies that report H. influenzae as the predominant pathogen in OME [8,14,35]. However, the reported prevalence rates are highly variable due to different health care programs, particularly vaccination, in various geographical locations [36].…”

“…The fact that most children were immunized with a pneumococcal conjugate vaccine possibly contributed to a lower incidence of S. pneumoniae. The identification of S. aureus in 42.86% of samples may look somewhat surprising, but a recent study also reports a high prevalence (27.78%) of S. aureus in MEF samples from OME cases [14]. Nevertheless, differences in pathogens' prevalence in studies conducted in the same country have been observed.…”

“…For instance, Alloiococcus otitis and Turicella otitidis have been detected by PCR or 16S rRNA gene sequencing with higher frequency from the MEF samples of OM patients [9][10][11][12][13]. Other bacterial species identified in OM cases with lower prevalence include, for instance, S. aureus and P. aeruginosa [8,11,14].…”

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

“…Consistent with previous publications, this study also demonstrated that RT-PCR was more sensitive than traditional culture techniques to the detection of bacterial otopathogens ( Ngo et al, 2016 ). This is due to the organism's fastidious growth requirements and the presence of viable organisms within a biofilm, which reduce the sensitivity of detection using culture ( Thornton et al, 2013 ; Niedzielski et al, 2021 ). In the current study, which was undertaken when the children were well, it is not possible to differentiate whether the magnitude of the difference between RT-PCR and culture results was technical or due to a lower bacterial load at the time of sampling.…”

Role of microRNAs as novel diagnostic biomarkers and potential therapeutic targets for hearing disorders (Review)

“…Of note, bacteria-induced meningitis has a cytotoxic effect on the cochlea and may lead to neural damage (73). In addition, even the middle ear can be affected by bacterial-induced inflammatory processes, of which otitis media with effusion and chronic suppurative otitis media are the most severe forms (74,75).…”