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Nasopharyngeal flora in otitis media with effusion. A comparative semiquantitative analysis
C Hemlin1, A Brauner, C Carenfelt
1Department of Otorhinolaryngology, Karolinska Hospital, Stockholm, Sweden.
Abstract:
An inflammatory process in the middle ear caused by bacteria or bacterial products emanating from the nasopharynx is one etiological factor considered in the unknown pathogenesis of otitis media with effusion (OME). The nasopharyngeal prevalence of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Branhamella) catarrhalis and Streptococcus pyogenes was studied in 191 children with defined OME and in 53 age-matched children without middle ear disease. Duplicate sampling and semiquantitative analysis were performed to assess even minor differences in the distribution of pathogens between the two groups of children. Pathogens were recovered in 91% of OME children. A significantly higher number of pathogen species/patient (1.66 vs. 1.15, p less than 0.01) as well as pathogen colonies/patient was found in OME children compared to control children. Chronic OME in children is associated with an increased pathogen load in the nasopharynx, suggesting a role of these pathogens in the etiology of OME.
Insights
Children with otitis media with effusion (OME) have a higher nasopharyngeal pathogen load. This suggests common bacteria like Streptococcus pneumoniae play a role in OME development.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Otitis media with effusion (OME) pathogenesis is not fully understood.
- Bacterial infections from the nasopharynx are a suspected etiological factor in OME.
Purpose of the Study:
- To investigate the nasopharyngeal prevalence of key bacterial pathogens in children with OME.
- To compare pathogen load between children with and without OME.
Main Methods:
- Studied nasopharyngeal bacterial prevalence in 191 children with OME and 53 controls.
- Utilized duplicate sampling and semiquantitative analysis for pathogen detection.
- Focused on Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes.
Main Results:
- Pathogens were detected in 91% of children with OME.
- Children with OME showed a significantly higher number of pathogen species per patient (1.66 vs. 1.15).
- A greater quantity of bacterial colonies per patient was observed in the OME group.
Conclusions:
- Chronic OME in children is linked to an increased bacterial load in the nasopharynx.
- These findings suggest a significant role for nasopharyngeal pathogens in the etiology of OME.