Detection Rates of Bacteria in Chronic Otitis Media with Effusion in Children

Park, Chul Won; Han, Jang Hee; Jeong, Jin Hyeok; Cho, Seok Hyun; Kang, Minho; Tae, Kyung; Lee, Seung Hwan

doi:10.3346/jkms.2004.19.5.735

Cited by 39 publications

(41 citation statements)

References 16 publications

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“…For example, H. influenzae persists in COPD (23,26), CF (35), and middle ear infections (31,32) despite intensive antibiotic therapies. Utilizing a novel in vitro coculture model, we recently described NTHi cells forming adherent, antibiotic-resistant biofilms on airway epithelia (42).…”

mentioning

confidence: 99%

Subinhibitory Concentrations of Azithromycin Decrease Nontypeable Haemophilus influenzae Biofilm Formation and Diminish Established Biofilms

Starner

Shrout

Parsek

et al. 2008

Antimicrob Agents Chemother

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Nontypeable Haemophilus influenzae (NTHi) commonly causes otitis media, chronic bronchitis in emphysema, and early airway infections in cystic fibrosis. Long-term, low-dose azithromycin has been shown to improve clinical outcomes in chronic lung diseases, although the mechanism of action remains unclear. The inhibition of bacterial biofilms by azithromycin has been postulated to be one mechanism mediating these effects. We hypothesized that subinhibitory concentrations of azithromycin would affect NTHi biofilm formation. Laboratory strains of NTHi expressing green fluorescent protein and azithromycin-resistant clinical isolates were grown in flow-cell and static-culture biofilm models. Using a range of concentrations of azithromycin and gentamicin, we measured the degree to which these antibiotics inhibited biofilm formation and persistence. Large biofilms formed over 2 to 4 days in a flow cell, displaying complex structures, including towers and channels. Subinhibitory concentrations of azithromycin significantly decreased biomass and maximal thickness in both forming and established NTHi biofilms. In contrast, subinhibitory concentrations of gentamicin had no effect on biofilm formation. Furthermore, established NTHi biofilms became resistant to gentamicin at concentrations far above the MIC. Biofilm formation of highly resistant clinical NTHi isolates (azithromycin MIC of >64 g/ml) was similarly decreased at subinhibitory azithromycin concentrations. Clinically obtainable azithromycin concentrations inhibited biofilms in all but the most highly resistant isolates. These data show that subinhibitory concentrations of azithromycin have antibiofilm properties, provide mechanistic insights, and supply an additional rationale for the use of azithromycin in chronic biofilm infections involving H. influenzae.

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mentioning

confidence: 99%

Subinhibitory Concentrations of Azithromycin Decrease Nontypeable Haemophilus influenzae Biofilm Formation and Diminish Established Biofilms

Starner

Shrout

Parsek

et al. 2008

Antimicrob Agents Chemother

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“…7 (18.42%) cases had previous history suggestive of AOM. AOM is more often present in age below 2 years as reported by many authors, 20% of those transforms into OME [14,15].…”

Section: Discussionmentioning

confidence: 84%

Prediction of Fluid Characteristics in Pediatric Otitis Media with Effusion from the Tympanometry

Sayed¹,

Mawgoud²,

Ghayes³

2017

Otolaryngol

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Objective: To correlate the characteristics of type B tympanogram with the type of middle ear fluid in children suffering from persistent OME. Methodology:A prospective study was conducted on children with persistent OME for more than 3 months who failed to respond to medical treatment with type B tympanogram in one or both ears and were candidate for myringotomy. The middle ear fluid was aspirated and the viscosity of the fluid was evaluated objectively by measuring the diameter of the diffusion circle on a filter paper in mm.Results: Thirty eight children (70 ears) were enrolled in this study. The shape of type B tympanogram was either flat (67.14%) or peaked (32.86 %).Three fluid types were noticed in OME namely serous, mucoid and glue. The shape was highly correlated with the type of secretions. Compliance and gradient of type B tympanogram were negatively correlated with the viscosity of the secretions. Conclusion:Tympanometry is a beneficial clinical tool in prediction, diagnosis and management of OME. Characteristics of type B tympanogram were correlated with the viscosity of middle ear fluid. Detailed analysis of type B tympanogram can assist the clinicians in determining the indication of comprehensive treatment.

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“…Persistent bacterial infection and associated chronic inflammation, causes Eustachian tube dysfunction, which itself is an important factor in leading to chronic OME. But 40-60% ears with OME were found with infectious agent [10,11]. This finding leads us to think the role of anti inflammatory agents as a treatment method, especially steroids in treatment.…”

Section: Discussionmentioning

confidence: 96%

“…This condition can be very difficult to treat, particularly in adults because, the treatment options still remain limited. Commonly used antibiotics have had limited impact in treating this condition [9] because about 40-60% of middle ear effusions were considered to be sterile in chronic OME when analyzed by bacterial culture [10,11].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Intratympanic Dexamethasone in Otitis Media with Effusion Resistant to Conventional Therapy

Paksoy¹,

Altın²,

Eken³

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The aim of this study was to determine the efficiency of intratympanic dexamethasone (ITD) injections as a new treatment modality in otitis media with effusion resistant to conventional therapy. We planned a nonrandomized prospective study to determine the safety and effectiveness of the direct administration of dexamethasone into middle ear cavity with chronic eustachian tube dysfunction. This study was applied on 75 ears of 64 patients aged from 12 to 60 years. ITD received 47 ears of 41 patients who had previously been treated by medical or surgical therapy middle ear effusion without resolution classified as study group. They were taken conventional medical therapy again 28 ears of 23 patients classified as a control group. ITDs were administered 0.5 ml/4 mg per mm directly in antero-superior quadrant of tympanic membrane. These injections were repeated once a week for 4 weeks. Results were evaluated by using audiometric and tympanometric measurements 1 and 3 months after the treatments. Audiometric measurement shows that 9.91 dB improvement in the mean air-bone gap 15.17 dB in air conduction (AC) pure-tone averages (PTA) and 5.25 dB bone conduction (BC) PTA. But the control group data showed only 2 dB improvement in the mean air-bone gap, 3 dB AC-PTA and 1.36 dB BC-PTA. Tympanometric improvement was found. In 28 ears of patients (59.6%) like type B or C converted to type A in study group without complication but only in three ears (10.7%) of control group. ITD administration to the middle ear is safe and effective for the treatment of otitis media with effusion or chronic eustachian tube dysfunction. No complications like tympanic membrane perforation and/or sensorineural hearing loss have occurred.

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Detection Rates of Bacteria in Chronic Otitis Media with Effusion in Children

Cited by 39 publications

References 16 publications

Subinhibitory Concentrations of Azithromycin Decrease Nontypeable Haemophilus influenzae Biofilm Formation and Diminish Established Biofilms

Subinhibitory Concentrations of Azithromycin Decrease Nontypeable Haemophilus influenzae Biofilm Formation and Diminish Established Biofilms

Prediction of Fluid Characteristics in Pediatric Otitis Media with Effusion from the Tympanometry

Effectiveness of Intratympanic Dexamethasone in Otitis Media with Effusion Resistant to Conventional Therapy

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