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Chlamydia pneumoniae in acute otitis media
S L Block1, M R Hammerschlag, J Hedrick
1Kentucky Pediatric Research Inc., Bardstown, USA.
Background:
Aerobic bacterial pathogens are recovered from 65 to 85% of patients with acute otitis media (AOM). Although Chlamydia pneumoniae is a common pathogen of pediatric pneumonia, it has rarely been cultured from children with chronic otitis media and its role in AOM is unknown.
Methods:
We cultured for C. pneumoniae in tympanocentesis aspirates and nasopharyngeal swabs from 101 consecutive, otherwise healthy children with AOM or refractory AOM. A control group of 50 similarly aged, healthy children was evaluated for nasopharyngeal carriage of C. pneumoniae. Specimens were also evaluated by PCR for C. pneumoniae.
Results:
C. pneumoniae was recovered by tympanocentesis in 8 (8%) of 101 children with AOM. Among the 8 children with C. pneumoniae-positive-AOM, 5 had C. pneumoniae detected by PCR in middle ear fluid, none had C. pneumoniae recovered by nasopharyngeal culture or PCR and 5 were younger than 16 months. C. pneumoniae was the sole pathogen isolated in 2 patients. Copathogens included beta-lactamase-positive positive Haemophilus influenzae (2), beta-lactamase positive Moraxella catarrhalis (1), penicillin-resistant Streptococcus pneumoniae (2) and penicillin-susceptible S. pneumoniae (1). C. pneumoniae was recovered from nasopharyngeal culture in 2 additional patients with C. pneumoniae-negative AOM and in none of 50 healthy control children, although 2 controls were positive by PCR from the nasopharynx.
Conclusions:
This is the first study to report the isolation of C. pneumoniae in middle ear fluid of children with AOM.
Insights
Chlamydia pneumoniae was identified in middle ear fluid of 8% of children with acute otitis media (AOM). This study is the first to isolate this pathogen from middle ear fluid in AOM cases.
Area of Science:
- Pediatric infectious diseases
- Otolaryngology
- Microbiology
Background:
- Acute otitis media (AOM) is frequently caused by aerobic bacterial pathogens.
- Chlamydia pneumoniae is a known cause of pediatric pneumonia but its role in AOM is unclear.
- Previous studies have rarely cultured C. pneumoniae from children with chronic otitis media.
Purpose of the Study:
- To investigate the presence and role of Chlamydia pneumoniae in acute otitis media (AOM) in children.
- To determine if C. pneumoniae can be isolated from middle ear fluid and nasopharyngeal swabs of children with AOM.
- To compare C. pneumoniae carriage in children with AOM versus healthy controls.
Main Methods:
- Cultured C. pneumoniae from tympanocentesis aspirates and nasopharyngeal swabs in 101 children with AOM.
- Utilized PCR to detect C. pneumoniae in collected specimens.
- Included a control group of 50 healthy children to assess nasopharyngeal carriage.
Main Results:
- C. pneumoniae was recovered from middle ear fluid in 8% of children with AOM.
- PCR confirmed C. pneumoniae in middle ear fluid for 5 of these cases.
- C. pneumoniae was found as the sole pathogen in 2 patients and co-occurred with other bacteria in others.
Conclusions:
- This study provides the first evidence of Chlamydia pneumoniae isolation from middle ear fluid in children diagnosed with acute otitis media (AOM).
- The findings suggest C. pneumoniae may play a role in pediatric AOM, particularly in younger children.
- Further research is warranted to understand the clinical significance and treatment implications of C. pneumoniae in AOM.