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The role of anaerobic bacteria in acute and chronic mastoiditis

Itzhak Brook1

  • 1Georgetown University School of Medicine, 4431 Albemarle Street NW, Washington, DC 20016, USA. ib6@georgetown.edu

Anaerobe
|May 17, 2006
PubMed

Insights

Mastoiditis, an ear infection complication, is rising due to antibiotic resistance. Treatment involves antibiotics and surgery for severe cases.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Microbiology

Background:

  • Mastoiditis (M) is the most frequent intratemporal complication of otitis media.
  • Antimicrobial agents have decreased M incidence, but a recent rise in acute M is noted, linked to resistant pneumococci.
  • Common pathogens include Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, and Haemophilus influenzae.

Purpose of the Study:

  • To review the epidemiology, microbiology, and management of mastoiditis.
  • To highlight the increasing incidence of acute mastoiditis and the role of antibiotic resistance.
  • To discuss the challenges in identifying causative organisms, particularly Pseudomonas aeruginosa and anaerobes.

Main Methods:

  • Literature review of studies on mastoiditis epidemiology, microbiology, and treatment.
  • Analysis of common bacterial isolates in acute and chronic mastoiditis.
  • Overview of current management strategies, including medical and surgical interventions.

Main Results:

  • While P. aeruginosa is increasingly identified, specimen contamination is a concern.
  • Anaerobic bacteria are predominant in chronic mastoiditis when appropriate isolation methods are used.
  • Treatment for uncomplicated mastoiditis includes parenteral antibiotics and myringotomy; surgical intervention like mastoidectomy is reserved for refractory cases.

Conclusions:

  • Mastoiditis management requires prompt antimicrobial therapy and surgical drainage when indicated.
  • Understanding the evolving microbiology, including resistant organisms, is crucial for effective treatment.
  • Adequate diagnostic methods are essential for identifying all causative pathogens, especially anaerobes.

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