Microbiology of acute otitis media in children with tympanostomy tubes: prevalences of bacteria and viruses.
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.
Ruohola
Aino
A
Department of Pediatrics, Turku University Hospital, Turku, FIN-20521, Finland. aino.ruohola@utu.fi
Meurman
Olli
O
Nikkari
Simo
S
Skottman
Tuukka
T
Salmi
Aimo
A
Waris
Matti
M
Osterback
Riikka
R
Eerola
Erkki
E
Allander
Tobias
T
Niesters
Hubert
H
Heikkinen
Terho
T
Ruuskanen
Olli
O
D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000382:microbiology*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008876:Middle Ear Ventilation / Q000009:adverse effects*; D010033:Otitis Media / Q000382:microbiology*; D014777:Virus Diseases / Q000821:virology*; D014780:Viruses / Q000145:classification / Q000302:isolation & purification*