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Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media

Kim Stol1, Suzanne J C Verhaegh, Kees Graamans

  • 1Department of Pediatrics, Radboud University Medical Centre, Nijmegen, The Netherlands.

International Journal of Pediatric Otorhinolaryngology
|February 2, 2013
PubMed
Abstract

Insights

Microbiological profiling did not differentiate recurrent acute otitis media (rAOM) from chronic otitis media with effusion (COME). Pathogen presence in middle ear fluid was linked to nasopharyngeal carriage in children with these common ear infections.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Otitis media (OM) is a common childhood illness.
  • Recurrent acute otitis media (rAOM) and chronic otitis media with effusion (COME) cause significant morbidity.
  • Differentiating rAOM and COME based on microbiology is important for treatment.

Purpose of the Study:

  • To investigate if microbiological profiling can distinguish between rAOM and COME in children.
  • To identify common bacterial and viral pathogens in middle ear fluid and nasopharyngeal samples.

Main Methods:

  • Prospective study of children under five with rAOM or COME undergoing tympanostomy tube insertion.
  • Collection of middle ear fluid and nasopharyngeal samples for bacterial culture and PCR.
  • Identification of key bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) and 15 respiratory viruses.

Main Results:

  • No significant difference in bacterial or viral pathogen occurrence in middle ear fluid between rAOM and COME groups.
  • Haemophilus influenzae and rhinovirus were predominant pathogens in both middle ear and nasopharynx.
  • Nasopharyngeal bacterial carriage correlated with middle ear fluid bacterial presence; isolates were genetically similar.

Conclusions:

  • The study challenges the notion that COME is typically sterile inflammation.
  • Microbiological findings suggest a potential link between nasopharyngeal carriage and middle ear infections in both rAOM and COME.
  • Reconsideration of the microbiological basis of rAOM versus COME is warranted.

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