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Streptococcus pneumoniae and Haemophilus influenzae in nasal cultures during acute otitis media
Abstract:
Middle ear fluid (MEF) aspirates and nasal swabs of children with acute otitis media (N = 255, age 2-6 yrs) were cultured by standard bacteriological methods. In addition, counterimmunoelectrophoresis and latex agglutination were applied to detect pneumococcal polysaccharide antigens (Pn-ag) in MEF. When the nasal culture grew Streptococcus pneumoniae (Pn), Pn was also present in 49% (73/148) and Pn-ag in 64% of the MEF cultures. If Haemophilus influenzae (Hi) appeared in the nasal culture. Hi was present in 41% (25/61) of the MEFs. There was a negative correlation between the growth of Pn or Hi in the nasal culture and the presence of other bacteria in the MEF. However, in spite of these correlations the nasal culture was concluded not to be useful in predicting the MEF bacteria.
Insights
Nasal swabs are not reliable for predicting middle ear fluid bacteria in children with acute otitis media. Streptococcus pneumoniae and Haemophilus influenzae detection in nasal cultures showed limited correlation with middle ear fluid findings.
Area of Science:
- Pediatrics
- Microbiology
- Infectious Diseases
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Identifying causative bacteria in middle ear fluid (MEF) is crucial for effective treatment.
- Nasal swabs are a less invasive sampling method compared to MEF aspiration.
Purpose of the Study:
- To evaluate the utility of nasal swabs in predicting bacterial pathogens in middle ear fluid (MEF) of children with AOM.
- To assess the correlation between nasal bacterial cultures and MEF cultures for Streptococcus pneumoniae and Haemophilus influenzae.
Main Methods:
- Standard bacteriological culturing of MEF aspirates and nasal swabs from 255 children (age 2-6 years) with AOM.
- Detection of pneumococcal polysaccharide antigens (Pn-ag) in MEF using counterimmunoelectrophoresis and latex agglutination.
- Correlation analysis between nasal and MEF bacterial findings.
Main Results:
- Streptococcus pneumoniae (Pn) was found in 49% of MEF when present in nasal cultures.
- Pneumococcal antigens (Pn-ag) were detected in 64% of MEF samples with nasal Pn.
- Haemophilus influenzae (Hi) was present in 41% of MEF when detected in nasal cultures.
- A negative correlation was observed between nasal Pn or Hi and other MEF bacteria.
Conclusions:
- Nasal cultures alone are insufficient for accurately predicting the bacterial pathogens present in middle ear fluid in children with AOM.
- While correlations exist for specific pathogens like S. pneumoniae and H. influenzae, the overall predictive value of nasal swabs is limited.
- Further research may be needed to identify more reliable non-invasive methods for diagnosing AOM pathogens.