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The association of particular types of Proteus with chronic suppurative otitis media
Abstract:
During a period of 12 months, 57 strains of Proteus were isolated from the ears of 38 unrelated patients with chronic suppurative otitis media. Each strain was identified, typed for bacteriocin production and sensitivity, and tested for Dienes compatibility. The majority of the strains (79%) were P. mirabilis; all but one of the remainder were P.vulgaris. Although 19 different bacteriocin production/sensitivity types were found, two rare types, P. mirabilis P7/S5,12 and P. vulgaris P0/S9, were associated with 47% of these infections. This was confirmed by Dienes typing. Patients with bilateral ear disease carried a different strain in each ear. There was no evidence that persistence of infection had arisen because of the development of antibiotic resistance. Although there was some evidence that persistence may have been the result of reinfection, the isolation of these rare types of Proteus from so many patients with chronic suppurative otitis media may indicate that they play an important role in the pathogenesis of the disease. Most of the Proteus isolates were of "non-faecal" types and it is believed that infection had arisen by a route other than the faecal-aural one.
Insights
Rare Proteus strains, P. mirabilis P7/S5,12 and P. vulgaris P0/S9, were linked to chronic suppurative otitis media infections. These non-faecal types may play a key role in disease development.
Area of Science:
- Microbiology
- Infectious Diseases
- Otolaryngology
Background:
- Chronic suppurative otitis media (CSOM) is a persistent ear infection.
- Proteus species are Gram-negative bacteria that can cause various infections.
Purpose of the Study:
- To investigate the role of Proteus strains in CSOM.
- To identify specific Proteus types associated with persistent ear infections.
Main Methods:
- Isolation and identification of 57 Proteus strains from 38 CSOM patients over 12 months.
- Bacteriocin production/sensitivity typing and Dienes compatibility testing.
- Analysis of strain prevalence and association with infection characteristics.
Main Results:
- Proteus mirabilis (79%) and Proteus vulgaris (20%) were the predominant species.
- Two rare types, P. mirabilis P7/S5,12 and P. vulgaris P0/S9, accounted for 47% of infections.
- No evidence of antibiotic resistance contributing to persistence; reinfection suggested as a possibility.
Conclusions:
- Specific rare Proteus strains may be significant in CSOM pathogenesis.
- The non-faecal origin suggests infection via routes other than the faecal-aural pathway.
- Further research into Proteus virulence factors in otitis media is warranted.