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The nasopharyngeal microflora of otitis-prone children, with emphasis on H. influenzae
Abstract:
The nasopharyngeal microflora was monitored during a prospective study of 52 otitis-prone children and 33 age-matched controls up to the age of 30 months. The relation between nasopharyngeal culture results and corresponding otoscopic findings was investigated. In contrast to pneumococci, the rate of H. influenzae isolation was correlated to the degree of otologic disease, thus it was found more often in connection with AOM than with a normal otologic status, with OME in an intermediate position. Also in contrast to pneumococci, in children with AOM, H. influenzae was commoner in the otitis-prone group than in the control group. H. influenzae biotype II was found in 77% in association with AOM in the control group. In the otitis-prone group the difference in frequency of biotypes I, II and III causing AOM were less pronounced. Turnover of H. influenzae strains as judged by change in biotype was found to occur more often in connection with treatments with penicillin-V than treatments with amoxicillin.
Insights
Haemophilus influenzae, not pneumococci, is linked to otitis media severity in children. Otitis-prone children show more H. influenzae during acute otitis media (AOM).
Area of Science:
- Microbiology
- Pediatrics
- Otology
Background:
- Otitis media (OM) is a common childhood illness.
- Nasopharyngeal microflora plays a role in OM pathogenesis.
- Identifying specific bacterial roles can inform treatment strategies.
Purpose of the Study:
- To investigate the relationship between nasopharyngeal microflora and otologic findings in children.
- To compare bacterial prevalence in otitis-prone children versus controls.
- To assess the impact of H. influenzae biotypes and antibiotic treatment on OM.
Main Methods:
- Prospective study of 52 otitis-prone children and 33 controls up to 30 months.
- Nasopharyngeal cultures and otoscopic examinations were performed.
- Analysis of H. influenzae isolation rates, biotypes, and correlation with disease severity and treatment.
Main Results:
- Haemophilus influenzae isolation rate correlated with otologic disease severity (AOM > OME > normal).
- H. influenzae was more frequent in otitis-prone children with AOM compared to controls.
- H. influenzae biotype II was predominant in controls with AOM; biotype distribution was more even in otitis-prone children.
- Strain turnover (biotype change) was more common with penicillin-V than amoxicillin treatment.
Conclusions:
- H. influenzae, particularly certain biotypes, is significantly associated with acute otitis media severity and otitis-prone status.
- Antibiotic choice (penicillin-V vs. amoxicillin) may influence H. influenzae strain dynamics during treatment.