Identification of the Bacterial Pathogens in Children with Otitis Media: A Study in the Northwestern Portuguese District of Braga.

Maria Daniela Silva,António Lima,Sanna Sillankorva,Miguel Gama,Nuno Marçal,Luís Dias

doi:10.3390/microorganisms10010054

Maria Daniela Silva, António Lima + Show 4 more

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https://doi.org/10.3390/microorganisms10010054

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Abstract

Understanding the bacterial etiology of otitis media (OM) is important when designing and evaluating the best course of treatment. This study analyzed middle ear fluid (MEF) and nasopharynx (NP) samples collected from 49 children with OM undergoing myringotomy in the northwestern Portuguese district of Braga. A correlation between species in the NP and MEF was observed following pathogen detection by culture and quantitative polymerase chain reaction (qPCR) methods. Bacterial identification using culturing methods showed that Moraxella catarrhalis was the most representative in NP and MEF, followed by Streptococcus pneumoniae. However, qPCR of MEF showed a higher prevalence (61%) of Haemophilus influenzae. S. pneumoniae was not the most frequently identified species, but it still remains one of the leading causes of OM in this region despite 93.9% of the children being vaccinated with the pneumococcal conjugate vaccine. Furthermore, 46% of the samples analyzed by qPCR identified more than two bacterial species. M. catarrhalis and S. pneumoniae were the most frequent combination identified in NP and MEF samples by culturing methods. Additionally, a few NP and MEF samples simultaneously presented the three main otopathogens. These results point out that polymicrobial infections play an important role in OM. Further studies characterizing the serotypes of the strains isolated, their resistance profile, and their biofilm forming ability would help in the development of more targeted strategies against otitis media.

Highlights

Microorganisms10010054 and CEB—Centre of Biological Engineering, LIBRO—Laboratório de Investigação em Biofilmes Rosário Oliveira, INL—International Iberian Nanotechnology Laboratory, Avenida Mestre José Veiga, 4715-330 Braga, Portugal
This study focused on children with Acute otitis media (AOM) with spontaneous otorrhea
Novel species, Alloiococcus and Turicella, are being identified at significant relative abundances in MEF samples using metagenomic DNA sequencing, which captures all available DNA in a non-discriminatory manner [36]. This is the first study investigating the prevalence of bacterial pathogens in the middle ear fluid of children with otitis media undergoing myringotomy in Portugal

Summary

Introduction

Microorganisms10010054 and CEB—Centre of Biological Engineering, LIBRO—Laboratório de Investigação em Biofilmes Rosário Oliveira, INL—International Iberian Nanotechnology Laboratory, Avenida Mestre José Veiga, 4715-330 Braga, Portugal. Catarrhalis and S. pneumoniae were the most frequent combination identified in NP and MEF samples by culturing methods. A few NP and MEF samples simultaneously presented the three main otopathogens. These results point out that polymicrobial infections play an important role in OM. In AOM, the presence of middle ear fluid (MEF) is accompanied by otalgia, otorrhea, and fever, among other signs and symptoms of an acute infection. In OME, which can be developed as a sequel to AOM or as a new onset after viral infection, MEF is present in the absence of signs and symptoms of infection, with the most common alteration detected being hearing loss [2]. Recurrent AOM (RAOM) are very common, as well as persistent OME (chronic OME, COME), with myringotomy and the insertion of ventilation tubes often being performed for their treatment [1]

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