Efficacy of nasopharyngeal culture in identification of pathogens in middle ear fluid in chronic otitis media with effusion

• Published in: Indian journal of medical microbiology Vol. 27; no. 3; p. 237
• Main Authors: Eser, OK, Ipci, K, Alp, S, Akyol, U, Unal, OF, Hascelik, G, Sennaroglu, L, Gur, D
• Format: Journal Article
• Language: English
• Published: Chandigarh Medknow Publications on behalf of Indian Association of Medical Microbiology 01-07-2009; Elsevier Limited
• Subjects: Bacteria; Bacterial infections; Chronic otitis media with effusion, Haemophilus influenzae, multiplex-PCR, Moraxella catarrhalis, Streptococcus pneumoniae; Microbiology; Streptococcus infections
• ISSN: 0255-0857; 1998-3646
• DOI: 10.4103/0255-0857.53206

Purpose: Chronic otitis media with effusion (OME) is the leading cause
of hearing loss during childhood. In bacterial etiology of OME, the
most frequent pathogens responsible are Haemophilus influenzae
followed by Streptococcus pneumoniae and Moraxella catarrhalis .
This study aimed at evaluating the accuracy of nasopharyngeal (NP)
specimens in the identification of pathogens in the middle ear fluid
(MEF) in patients with OME. Materials and Methods: In this cross
sectional, case-control study, 95 MEFs and 53 NP secretion specimens
were obtained from 53 children. As a control group, 102 NP specimens
were taken from children having an operation other than an otological
disease. Conventional culture methods and multiplex-PCR method have
been used to determine the etiology of OME; NP carriage between cases
and control groups were compared using conventional culture methods.
Pearson Chi-Square and Fisher′s Exact tests were used in
statistical analysis. Results : Bacteria were isolated by culture in
37.9% of MEF specimens, 14.7% of which belonged to the group H.
influenzae , S. pneumoniae and M. catarrhalis. PCR was positive in
30.5% specimens targeting the same pathogens. There was a two-fold
increase in carriage rate of S. pneumoniae and H. influenzae in
patients than controls for each pathogen. Conclusion: PCR is a more
reliable method to detect middle ear pathogens in MEF in comparison
with the conventional culture methods. The NP colonization wasn′t
found to be an indicator of the pathogen in MEF although middle ear
pathogens colonize more in nasopharynx of diseased children.