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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.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|January 1, 1993
PubMed

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.

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