title: Impact of antibiotics on pathogens associated with otitis media with effusion.
abstract: OBJECTIVE
  To further understand the roles of bacteria and antibiotics in the development of otitis media with effusion (OME).
  
  
  METHODS
  Samples of middle-ear effusion (MEE) were collected during the placement of ventilation tubes to treat chronic OME. Children with acute otitis media within the past three months were excluded from this study. We used polymerase chain reaction (PCR) to detect pathogens and to test the susceptibility of Streptococcus pneumoniae to penicillin.
  
  
  RESULTS
  Among MEE samples from 52 children, PCR detected bacterial DNA in 32 per cent (24/75) of them. S. pneumoniae was detected more frequently in middle ears that required ventilation tube insertion at least twice compared with those requiring ventilation tube insertion only once (5/15 versus 4/60; p = 0.013). Higher levels of S. pneumoniae were detected in MEE from children with, than without, a long history of antibiotic administration (7/10 versus 2/14; p = 0.0187). The pbp genes of all isolated S. pneumoniae contained mutations.
  
  
  CONCLUSIONS
  Long exposure to antibiotics might significantly influence the bacterial genome in MEE.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hamamoto
authors.forename: Yukako
authors.initials: Y
authors.lastname: Gotoh
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Nakajo
authors.forename: Satoko
authors.initials: S
authors.lastname: Shimoya
authors.forename: Chikako
authors.initials: C
authors.lastname: Kayama
authors.forename: Shingo
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Nibu
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D015373:Bacterial Typing Techniques / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004269:DNA, Bacterial / Q000032:analysis; D004334:Drug Administration Schedule; D024881:Drug Resistance, Bacterial; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008876:Middle Ear Ventilation; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D009154:Mutation; D010034:Otitis Media with Effusion / Q000382:microbiology* / Q000601:surgery; D046915:Penicillin-Binding Proteins / Q000235:genetics; D010406:Penicillins / Q000494:pharmacology; D016133:Polymerase Chain Reaction; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D046915:Penicillin-Binding Proteins; D010406:Penicillins