title: Microbiology of acute otitis media in children with tympanostomy tubes: prevalences of bacteria and viruses.
abstract: 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.
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, FIN-20521, Finland. aino.ruohola@utu.fi
authors.forename: Aino
authors.initials: A
authors.lastname: Ruohola
authors.forename: Olli
authors.initials: O
authors.lastname: Meurman
authors.forename: Simo
authors.initials: S
authors.lastname: Nikkari
authors.forename: Tuukka
authors.initials: T
authors.lastname: Skottman
authors.forename: Aimo
authors.initials: A
authors.lastname: Salmi
authors.forename: Matti
authors.initials: M
authors.lastname: Waris
authors.forename: Riikka
authors.initials: R
authors.lastname: Osterback
authors.forename: Erkki
authors.initials: E
authors.lastname: Eerola
authors.forename: Tobias
authors.initials: T
authors.lastname: Allander
authors.forename: Hubert
authors.initials: H
authors.lastname: Niesters
authors.forename: Terho
authors.initials: T
authors.lastname: Heikkinen
authors.forename: Olli
authors.initials: O
authors.lastname: Ruuskanen
mesh_terms: 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*