Differences in nasopharyngeal bacterial flora in children with nonsevere recurrent acute otitis media and chronic otitis media with effusion: implications for management

Marchisio, Paola; Claut, Laura; Rognoni, Alessandro; Esposito, Susanna; Passàli, Desiderio; Bellussi, Luisa; Drago, Lorenzo; Pozzi, Gianni; Mannelli, Stefania; Schito, G. C.; Principi, Nicola

doi:10.1097/01.inf.0000055063.40314.da

Cited by 47 publications

(49 citation statements)

References 28 publications

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“…Marchisio et al [26] showed that microbial colonization of the nasopharynx and their resistance patterns are different in patients with OME compared to non-OME cases, which is in contrast to our findings. This difference may be due to geographical varieties or their different antibiotic therapy policy.…”

Section: Resultscontrasting

confidence: 84%

Evaluation of nasopharyngeal microbial flora and antibiogram and its relation to otitis media with effusion

Nourizadeh

Ghazvini

Gharavi

et al. 2015

Eur Arch Otorhinolaryngol

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Acute otitis media and otitis media with effusion (OME) are the main causes of hearing impairment in children which require proper treatment, mainly antibiotic therapy. Patients whom were appropriate candidates for adenoidectomy were divided into two groups regarding the presence of middle ear effusion. Adenoid tissue specimens were cultured in both groups and the bacterial flora and anti-microbial resistance pattern were determined. 72 patients were studied, 42 % had OME while 58 % did not. The following bacteria were isolated and cultured from both groups with no meaningful difference in prevalence: Streptococcus viridans (p = 0.265), Staphylococcus aureus (p = 0.72), H. influenza (p = 0.806), Entrococcus. spp (0.391), Streptococcus pneumonia (p = 0.391), nonhemolytic Streptococcus (p = 0.230). Bacterial sensitivity was similar for Amoxicillin-clavulanate (p = 0.935), Amoxicillin (p = 0.935), Cephalexin (p = 0.806), Cefixime (p = 0.391) and Azithromycin in both groups. The two groups showed no meaningful difference considering the bacterial flora of nasopharynx and their sensitivity. Bacteria in both groups were sensitive to Amoxicillin and Amoxicillin-clavulanate and resistant to Azithromycin, Cefixime and Cephalexin.

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Section: Resultscontrasting

confidence: 84%

Evaluation of nasopharyngeal microbial flora and antibiogram and its relation to otitis media with effusion

Nourizadeh

Ghazvini

Gharavi

et al. 2015

Eur Arch Otorhinolaryngol

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“…(iv) The majority of sequences could be classified only at the genus level. Increased numbers of alpha-hemolytic streptococci have been isolated from the nasopharynx of healthy children compared to those for OM-prone children (43,59). We could not achieve specieslevel identification of alpha-hemolytic streptococci using shortread 16S rRNA pyrosequencing technologies.…”

Section: Discussionmentioning

confidence: 99%

Upper Respiratory Tract Microbial Communities, Acute Otitis Media Pathogens, and Antibiotic Use in Healthy and Sick Children

Pettigrew

Laufer

Gent

et al. 2012

Appl Environ Microbiol

164

153

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ABSTRACTThe composition of the upper respiratory tract microbial community may influence the risk for colonization by the acute otitis media (AOM) pathogensStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalis. We used culture-independent methods to describe upper respiratory tract microbial communities in healthy children and children with upper respiratory tract infection with and without concurrent AOM. Nasal swabs and data were collected in a cross-sectional study of 240 children between 6 months and 3 years of age. Swabs were cultured forS. pneumoniae, and real-time PCR was used to identifyS. pneumoniae,H. influenzae, andM. catarrhalis. The V1-V2 16S rRNA gene regions were sequenced using 454 pyrosequencing. Microbial communities were described using a taxon-based approach. Colonization byS. pneumoniae,H. influenzae, andM. catarrhaliswas associated with lower levels of diversity in upper respiratory tract flora. We identified commensal taxa that were negatively associated with colonization by each AOM bacterial pathogen and with AOM. The balance of these relationships differed according to the colonizing AOM pathogen and history of antibiotic use. Children with antibiotic use in the past 6 months and a greater abundance of taxa, includingLactococcusandPropionibacterium, were less likely to have AOM than healthy children (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.25 to 0.85). Children with no antibiotic use in the past 6 months, a low abundance ofStreptococcusandHaemophilus, and a high abundance ofCorynebacteriumandDolosigranulumwere less likely to have AOM (OR, 0.51; 95% CI, 0.31 to 0.83). An increased understanding of polymicrobial interactions will facilitate the development of effective AOM prevention strategies.

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“…The association with bronchopulmonary infections occurs because AOM and most lower respiratory tract infections (LRTI) are alternate (or common) outcomes of nasopharyngeal colonization by the same species of respiratory pathogens. Because mortality due to LRTI (Schluger 2010) is more prevalent than that due to intracranial spread of middle ear infection (Monasta et al 2012, WHO 2004 First the pathogens causing rAOM are the same as those causing AOM (Pichichero 2000), but children prone to rAOM experience nasopharyngeal bacterial colonisation more frequently (Faden et al 1991, Harabuchi et al 1994 and with higher density (Stenfors & Raisanen 1992), although this may also be found in children with COME (Marchisio et al 2003)). Quantitative or qualitative defects in plasma immunoglobulins have been found in some, but not all, of those with rAOM (Freijd et al 1984, Freijd et al 1985, Harsten et al 1989, Hotomi et al 1999, Prellner et al 1984b, Stenfors & Raisanen 1993, Yamanaka & Faden 1993.…”

Section: Susceptibility To Raommentioning

confidence: 91%

Evolution and Otitis Media: A Review, and a Model to Explain High Prevalence in Indigenous Populations

Bhutta¹

2015

Human Biology

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Inflammation of the middle ear (otitis media) comprises a group of disorders that are highly prevalent in childhood, and indeed are amongst the most common disorders of childhood. Otitis media is also heritable, and has effects on fecundity. This means that otitis media is subject to evolution, yet the evolutionary selection forces that may determine susceptibility to otitis media have never been adequately explored.Here I undertake a critical analysis of evolutionary forces that may determine susceptibility to middle ear inflammation. These forces include those determining function of the middle ear, those affecting host immunity, and those affecting colonization by, and pathogenicity of bacteria. I review existing mathematical evolutionary models of host-pathogen interaction and co-evolution, and apply these to develop a better understanding of the complex evolutionary landscape of middle ear infection and inflammation in humans. This includes an understanding of factors Pre--print version. Visit http://digitalcommons.wayne.edu/humbiol/ after 1 October 2015 to acquire the final version.2 determining the transition between stable evolutionary strategies for host and bacterial pathogens. This understanding will be later applied to analysis of otitis media in indigenous populations.In the second part of this article, I apply the approach of population genetics to devise a new theory for the high prevalence of otitis media in certain indigenous populations: the Australian Aborigine, the Native American, the Inuit, and the Maori.I suggest that high prevalence in such groups may have occurred as a result of colonization of these previously isolated populations by European immigrants in the 15 th and 16 th Centuries. This exposed them to new strains of bacteria to which their immune system had not evolved immunity, perturbing a previously stable hostpathogen co-evolutionary state.

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Differences in nasopharyngeal bacterial flora in children with nonsevere recurrent acute otitis media and chronic otitis media with effusion: implications for management

Abstract: There are substantial differences in nasopharyngeal flora between children with nonsevere rAOM and children with cOME. The results of nasopharyngeal cultures should be taken into account to avoid treatment with drugs that are ineffective and likely to select resistant organisms.

Cited by 47 publications

References 28 publications

Evaluation of nasopharyngeal microbial flora and antibiogram and its relation to otitis media with effusion

Evaluation of nasopharyngeal microbial flora and antibiogram and its relation to otitis media with effusion

Upper Respiratory Tract Microbial Communities, Acute Otitis Media Pathogens, and Antibiotic Use in Healthy and Sick Children

Evolution and Otitis Media: A Review, and a Model to Explain High Prevalence in Indigenous Populations

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