Adenoid Bacteriology in Otitis Media Children With Effusion

Abstract

Objectives: The relationship between the adenoids and otitis media has been well documented. The purpose of this study was to document the current trends in the bacteriology of the adenoids in children with otitis media with effusion (OME). Comparisons of bacteriology of the adenoids with that of the middle ear fluid are made, and the role of adenoidectomy in treating otitis media with effusion is discussed. Methods: A prospective investigation of 44 patients with adenoid hyperplasia and OME was performed. All patients received transoral endoscopic adenoidectomy and insertion of tympanostomy tubes. The core adenoid tissue and middle ear fluid were cultured. Presumptive pathogens were identified using standard methods. Results: The age range of the patients was 3 to 14 years with a mean age of 6.95years; 31 patients were male and 13 were female. Microorganisms were isolated in the core adenoid tissue in 84% (37/44) of the patients and more than two microorganisms were isolated in 41% (20/44) of the patients. Possible pathogenic microorganisms were present in 41% (29/70) of the samples. The most common pathogenic microorganisms were Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa. Possible nonpathogenic microorganisms were present in59% (41/70) of the samples. Streptococcus viridans, Neisseria species and coagulase(-) Staphylococcus were the most common. Only one isolate of Neisseria species(2.9%) was cultured from the middle ear effusion. Conclusions: Our results suggest that the adenoidal reservoir of bacteria may be associated with otitis media with effusion. Although we did not find a significant association between bacteriology of the adenoids and that of middle ear effusion, a significant portion of the reservoir bacteria were pathogenic microorganisms and some of them were oxacillin-resistant or β-lactamase positive. The clinical benefits of adenoidectomy in the health management of children with otitis media with effusion should not be overlooked.