Pneumococcal bacteriology after pneumococcal otitis media with special reference to pneumococcal antigens

Area of Science:

• Pediatrics
• Infectious Diseases
• Otolaryngology

Background:

• Acute otitis media (AOM) is common in infants.
• Prolonged or recurrent AOM and secretory otitis media (SOM) can have significant impacts.
• The role of Streptococcus pneumoniae (pneumococcus) persistence in these conditions requires further investigation.

Purpose of the Study:

• To investigate the persistence of pneumococcus (Pn) and pneumococcal antigen (Pn-ag) in middle ear fluid (MEF) following initial AOM.
• To determine the occurrence of Pn and Pn-ag in MEF of ears with prolonged, recurrent, or secretory otitis media (SOM).

Main Methods:

• Observation of 54 ears in 38 infants with initial AOM for 7-22 months.
• Detection of Pn by culture and Pn-ag by counterimmunoelectrophoresis or latex agglutination in MEF.
• Analysis of 151 SOM ears in 97 children for Pn-ag presence.

Main Results:

• Pn and/or Pn-ag were detected in 24% to 9% of ears during the initial 3 months post-AOM, with new types appearing later.
• Persistent Pn-ag with culturable Pn was found in only 2 of 9 MEFs lasting ≥3 months, for no longer than 5 months.
• Pn-ag was detected in only 1 of 12 ears that developed SOM, and in 7 of 151 SOM ears.

Conclusions:

• The persistence of pneumococcal antigens in middle ear fluid after AOM is limited.
• The occurrence of pneumococcal antigens in middle ear fluid during secretory otitis media is rare.
• The role of persistent pneumococcal antigens in prolonged, recurrent, or secretory otitis media appears questionable.