Bacterial aetiology of chronic otitis media with effusion in children - risk factors

Abstract

Background Otitis media with effusion (OME) may occur spontaneously because of poor Eustachian tube function or as an inflammatory response following AOM. Bacterial involvement in OME has been widely reported, with various available methods to identify pathogens from middle ear effusion, including traditional culture methods and polymerase chain reaction (PCR). Objectives The primary goal of this study was to evaluate the bacteriological profile of middle ear effusion in OME. Risk factors of the bacterial OME aetiology were also identified. Methods Middle ear effusions (MEF) from 50 children, aged 2–8 years, diagnosed by ENT and undergoing routine tympanostomy tube placement were collected. MEF samples were streaked on standard microbiological media. Next, DNA was isolated from MEF samples and analysed with multiplex PCR for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Alloiococcus otitidis. Results In multiplex PCR assay 37 (74%) of 50 children were positive for at least one of the four microorganisms. In 27.0% positive children multiple bacterial pathogens were identified. A. otitidis was the most frequently identified in positive MEF children (59.5%). By multiplex PCR, H. influenzae, S. pneumoniae and M. catarrhalis were detected in 24, 18 and 8% of OME patients, respectively. There was significant association between bilateral infection and H. influenzae aetiology of OME. Conclusions Overall we found OME predominantly a single otopathogen infection caused mainly by A. otitidis, which is difficult in identification using standard culture method, ahead to S. pneumoniae and H. influenzae. However, one third of MEF samples had multiple bacterial pathogens.

Effects of the Traditional Mediterranean Diet in Patients with Otitis Media with Effusion

“…The changes in the levels of citocines, may indicate bacterial pathogen as one of the causes of OME [45]. The presence of Alloiococcus otitidis has been considered as a precipitating factor of OME [46]. Likewise, the importance of "bacterial biofilm" and its association with persistent otic disease has been observed [47][48][49].…”

Identification of the Bacterial Pathogens in Children with Otitis Media: A Study in the Northwestern Portuguese District of Braga

“…Moreover, using the universal SYBR Green fluorescent dye instead of specific probes for each bacterial pathogen could have reduced the specificity of the qPCR reactions. Furthermore, the presence of other pathogens, such as A. otitis, which may play an important role in both AOM and OME [47,48], was not assessed. Indeed, novel species, particularly Alloiococcus and Turicella, are being identified at significant relative abundances in MEF samples using metagenomic DNA sequencing, which captures all available DNA in a non-discriminatory manner [36].…”

Effects of the Traditional Mediterranean Diet in Patients with Otitis Media with Effusion

“…The changes in the levels of citocines, may indicate bacterial pathogen as one of the causes of OME [42]. The presence of Alloiococcus otitidis has been considered as a precipitating factor of OME [43]. Likewise, the importance of "bacterial biofilm" and its association with persistent otic disease has been observed [44,45,46].…”