Panel 5: Microbiology and Immunology Panel

Abstract

Objective The objective is to perform a comprehensive review of the literature from January 2007 through June 2011 on the virology, bacteriology, and immunology related to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Three subpanels with co-chairs comprising experts in the virology, bacteriology, and immunology of otitis media were formed. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a second draft was created. The entire panel met at the 10th International Symposium on Recent Advances in Otitis Media in June 2011 and discussed the review and refined the content further. A final draft was created, circulated, and approved by the panel. Conclusion Excellent progress has been made in the past 4 years in advancing an understanding of the microbiology and immunology of otitis media. Advances include laboratory-based basic studies, cell-based assays, work in animal models, and clinical studies. Implications for Practice The advances of the past 4 years formed the basis of a series of short-term and long-term research goals in an effort to guide the field. Accomplishing these goals will provide opportunities for the development of novel interventions, including new ways to better treat and prevent otitis media.

Update on otitis media – prevention and treatment

“…Viral upper respiratory tract infections often precede or coincide with episodes of AOM; examples include respiratory syncytial virus, adenovirus, and cytomegalovirus 27. Viral infections are now thought to have a pivotal role in AOM progression, and recent randomized controlled trials have demonstrated the role of antiviral treatment for AOM 28.…”

“… 25 , 26 Viral upper respiratory tract infections often precede or coincide with episodes of AOM; examples include respiratory syncytial virus, adenovirus, and cytomegalovirus. 27 Viral infections are now thought to have a pivotal role in AOM progression, and recent randomized controlled trials have demonstrated the role of antiviral treatment for AOM. 28 It is thought that viral infection of the nasopharynx creates an environment that promotes bacterial colonization, adhesion to cells, and invasion of the middle ear.…”

“… 28 It is thought that viral infection of the nasopharynx creates an environment that promotes bacterial colonization, adhesion to cells, and invasion of the middle ear. 27 …”

“…During this inflammatory period, the middle ear ossicles are less mobile and may be subject to resorption, 32 which could even lead to permanent conductive hearing loss. Studies have described patients with smaller mastoid cavities as having greater risk of developing chronic middle ear disease; 27 however, whether this effect is causative is controversial. Patients with chronic infection may also develop sensorineural hearing loss secondary to ototoxicity.…”

Vinpocetine Suppresses Streptococcus pneumoniae–Induced Inflammation via Inhibition of ERK1 by CYLD

“…Because OM causes hearing loss during a crucial period for speech and language development, children with frequent middle ear infections may suffer speech and language disabilities (1)(2)(3). Streptococcus pneumoniae is a major Gram-positive bacterium causing OM (2,8,9). Current S. pneumoniae vaccines have a limited impact on OM, and inappropriate antibiotic use increased antibiotic resistance (9)(10)(11)(12).…”