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The clinical role of Alloiococcus otitidis in otitis media with effusion
Kimmo Leskinen1, Panu Hendolin, Anni Virolainen-Julkunen
1Department of Otolaryngology, Helsinki University Central Hospital, Haartmaninkatu 4 E, PO Box 220, FIN-00029 HUCH, Helsinki, Finland. kimmo.leskinen@hus.fi
Objective:
To investigate the presence of Alloiococcus otitidis (A. otitidis) in MEEs from patients with otitis media with effusion (OME) using PCR and to correlate the findings with the clinical picture of children with OME for assessing the clinical role of A. otitidis in OME.
Methods:
Bacterial culture and PCR were used to detect A. otitidis, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in MEE samples from 123 patients with OME. The culture and PCR results and the clinical picture of the patients were compared.
Results:
Bacteria were cultured in 55 (45%) of the 123 MEEs, and major pathogens (S. pneumoniae, H. influenzae and M. catarrhalis) were found in 40 (33%); A. otitidis was not found in culture. PCR of the MEEs yielded positive results for one or more of the four tested pathogens in 108 (88%) of the samples and 25 (20%) were positive for A. otitidis. The effusions that persisted 3 months or longer had a higher prevalence of A. otitidis than those with shorter durations (P=0.03). A. otitidis was found to be more often positive in PCR in mucoid MEEs than in mucoserous MEEs (30 vs. 9%; P=0.015).
Conclusions:
While A. otitidis is extremely difficult to detect with bacterial culture, PCR provides a sensitive and specific means for detecting it. A. otitidis is associated with a more prolonged course and mucoid MEEs in OME. Thus, its existence seems to be related to a more chronic stage of OME, but its pathogenic potential should be the subject of further investigation.
Insights
Alloiococcus otitidis is difficult to detect by culture but identifiable by PCR in middle ear effusions (MEEs). This bacterium is linked to prolonged otitis media with effusion (OME) and mucoid MEEs.
Area of Science:
- Otolaryngology
- Microbiology
- Pediatrics
Background:
- Otitis media with effusion (OME) is a common pediatric condition.
- The role of specific bacteria, such as Alloiococcus otitidis (A. otitidis), in OME pathogenesis remains unclear.
- Traditional bacterial culture methods often fail to detect certain microorganisms in middle ear effusions (MEEs).
Purpose of the Study:
- To detect A. otitidis in MEEs from OME patients using polymerase chain reaction (PCR).
- To correlate the presence of A. otitidis with clinical characteristics of OME in children.
- To assess the clinical significance of A. otitidis in OME.
Main Methods:
- MEE samples were collected from 123 children diagnosed with OME.
- Bacterial culture and PCR were employed to identify A. otitidis, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
- Clinical data and effusion characteristics were compared with microbiological findings.
Main Results:
- A. otitidis was not detected by bacterial culture but was identified in 20% of MEE samples via PCR.
- PCR detected one or more major pathogens in 88% of MEEs.
- A. otitidis detection by PCR was significantly associated with longer effusion duration (≥3 months) and mucoid MEEs.
Conclusions:
- PCR is a more sensitive method than bacterial culture for detecting A. otitidis in MEEs.
- A. otitidis is associated with chronic OME, characterized by prolonged effusion and mucoid secretions.
- Further research is warranted to elucidate the pathogenic role of A. otitidis in OME.