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Acute childhood otitis media: the diagnostic value of bacterial samples from the nasopharynx

Pierre Gehanno1, Béatrix Barry, Patrick Berche

  • 1Service d'Otorhinolaryngologie, Hôpital Bichat, Claude Bernard, 75877 Paris, France.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|June 1, 1997
PubMed

Insights

Comparing middle ear otorrhea and rhinopharyngeal samples for acute otitis media (AOM) in children, this study found rhinopharyngeal samples have low predictive value for pathogens. However, antibiotic sensitivity showed good correlation between both sample types.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Acute otitis media (AOM) is a common childhood infection.
  • Identifying causative pathogens and their antibiotic susceptibility is crucial for effective treatment.

Purpose of the Study:

  • To compare the bacteriologic findings from middle ear otorrhea and rhinopharyngeal samples in children with AOM.
  • To assess the utility of rhinopharyngeal cultures in predicting pathogens responsible for AOM.

Main Methods:

  • A prospective study involving 354 children diagnosed with AOM.
  • Collection of paired samples: middle ear fluid (otorrhea) and nasopharyngeal swabs.
  • Bacteriologic analysis and antibiotic susceptibility testing of all collected samples.

Main Results:

  • Rhinopharyngeal samples demonstrated a low predictive value (30%) for identifying the specific pathogen causing AOM.
  • A strong correlation was observed in antibiotic sensitivity patterns between middle ear otorrhea and rhinopharyngeal samples across the entire study population.
  • This suggests nasopharyngeal cultures may reflect overall antibiotic resistance trends.

Conclusions:

  • While rhinopharyngeal cultures are poor predictors of individual AOM pathogens, they possess significant collective epidemiologic value.
  • Promoting the collection of nasopharyngeal cultures is recommended for monitoring trends in antibiotic susceptibility, particularly for Streptococcus pneumoniae in children.
  • This approach aids in public health surveillance and antimicrobial stewardship efforts.

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