Related Experiment Videos
The microbiology of acute and chronic sinusitis and otitis media:a review
P B van Cauwenberge1, A M Vander Mijnsbrugge, K J Ingels
1Department of Otorhinolaryngology, University Hospital, Ghent, Belgium.
Abstract:
There exists no real controversy about the role of aerobic bacteria in acute sinusitis and in acute otitis media. The "infernal trio" Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are by far the most common pathogens in these acute infections. On the contrary, there is still much debate about the normal flora of the paranasal sinuses and the middle ear, although there are some reports of the presence of anaerobes and aerobes in the majority of the normal paranasal sinuses. In chronic sinusitis bacteriological cultures show a greater variation than those in acute sinusitis. Nonetheless, it is demonstrated in most studies that besides the "infernal trio" additional bacteria are present, including anaerobes and gram negative bacteria. In otitis media with effusion (OME) we find the same bacteria as in acute otitis media (AOM) and a pathologic flora in the nasopharynx seems to be important for both AOM and OME. In chronic otitis cultures are nearly always positive and reveal Pseudomonas species, Klebsiella pneumoniae, Staphylococcus aureus, Proteus species and anaerobes.
Insights
Aerobic bacteria are key in acute sinusitis and otitis media, with Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis being common. Chronic infections show more varied bacteria, including anaerobes and gram-negative species.
Area of Science:
- Microbiology
- Otolaryngology
Background:
- The role of aerobic bacteria in acute sinusitis and otitis media is well-established.
- The normal flora of paranasal sinuses and middle ear remains debated, with some studies reporting anaerobes and aerobes.
Purpose of the Study:
- To review the bacteriology of acute and chronic sinusitis and otitis media.
- To differentiate between pathogens in acute versus chronic infections.
Main Methods:
- Review of bacteriological culture findings from existing studies on sinusitis and otitis media.
- Analysis of common bacterial pathogens identified in various middle ear and sinus conditions.
Main Results:
- The "infernal trio" (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) are primary pathogens in acute infections.
- Chronic sinusitis involves greater bacterial diversity, including anaerobes and gram-negative bacteria.
- Otitis media with effusion shares pathogens with acute otitis media, linked to nasopharyngeal flora. Chronic otitis cultures frequently yield Pseudomonas, Klebsiella pneumoniae, Staphylococcus aureus, Proteus, and anaerobes.
Conclusions:
- Bacterial profiles differ significantly between acute and chronic sinusitis and otitis media.
- Understanding these distinct microbial communities is crucial for effective treatment strategies.