Microbiology of Acute Otitis Media in Children with Tympanostomy Tubes: Prevalences of Bacteria and Viruses

• Published in: Clinical infectious diseases Vol. 43; no. 11; pp. 1417 - 1422
• Main Authors: Ruohola, Aino, Meurman, Olli, Nikkari, Simo, Skottman, Tuukka, Salmi, Aimo, Waris, Matti, Österback, Riikka, Eerola, Erkki, Allander, Tobias, Niesters, Hubert, Heikkinen, Terho, Ruuskanen, Olli
• Format: Journal Article
• Language: English
• Published: United States The University of Chicago Press 01-12-2006; University of Chicago Press; Oxford University Press
• Subjects: and Commentaries; Articles and Commentaries; Bacteria; Bacteria - classification; Bacteria - isolation & purification; Bacterial Infections - microbiology; Child, Preschool; Children; Children & youth; Coinfection; Ear diseases; Etiology; Humans; Infant; Medicin och hälsovetenskap; Microbiology; Middle ear; Middle ear ventilation; Middle Ear Ventilation - adverse effects; Otitis media; Otitis Media - microbiology; Picornaviridae; Polymerase chain reaction; Virus Diseases - virology; Viruses; Viruses - classification; Viruses - isolation & purification
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/509332

Background. Bacteria are found in 50%–90% of cases of acute otitis media (AOM) with or without otorrhea, and viruses are found in 20%–49% of cases. However, for at least 15% of patients with AOM, the microbiological etiology is never determined. Our aim was to specify the full etiology of acute middle ear infection by using modern microbiological methods concomitantly for bacterial and viral detection. Methods. The subjects were 79 young children having AOM with new onset (<48 h) of otorrhea through a tympanostomy tube. Middle ear fluid samples were suctioned from the middle ear through the tympanostomy tube. Bacteria were sought by culture and polymerase chain reaction; viruses were analyzed by culture, antigen detection, and polymerase chain reaction. Results. At least 1 respiratory tract pathogen was noted in 76 children (96%). Bacteria were found in 73 cases (92%), and viruses were found in 55 (70%). In 52 patients (66%), both bacteria and viruses were found. Bacteria typical of AOM were detected in 86% of patients. Picornaviruses accounted for 60% of all viral findings. Conclusions. In the great majority of children, AOM is a coinfection with bacteria and viruses. The patent tympanostomy tube does not change the spectrum of causative agents in AOM. A microbiological etiology can be established in practically all cases.