title: The relationship between chronic otitis media with effusion and surface and deep flora of hypertrophic adenoids.
abstract: OBJECTIVE
  The relationship between bacterial flora of the adenoids and middle ear problems is unclear. In this study, superficial and deep aerobic and anaerobic bacterial flora of adenoid tissues were compared in children with and without chronic otitis media with effusion (cOME).
  
  
  METHODS
  Between 2004 and 2007, family members of children (ages 1-14 years) who were scheduled to undergo adenoidectomy were approached for participation in the study. Of the 180 patients who gave consent, 107 (59%) did not have cOME (Group I), whereas 73 (41%) had had a tympanostomy tube previously due to cOME (Group II). Prior to adenoidectomy, swabs were taken from the surface of the adenoids, and samples of deep tissue for culture were obtained from curetted tissue. All samples were cultured aerobically and anaerobically. Growth of 10 of the bacteria most commonly cultured were evaluated: 5 classified as normal flora (coagulase-negative staphylococci, α-hemolytic streptococci, Neisseria spp., Prevotella spp. ve Peptostreptococci) and 5 potential pathogens (S. aureus, S. pyogenes, S. pneumoniae, H. influenzae ve Moraxella spp.).
  
  
  RESULTS
  Isolation rates of potential pathogens including S. pneumoniae,H. influenzae and Moraxella spp. from surface and deep cultures of adenoids were between 5 and 15% (no significant differences between those with and without cOME). While S. aureus was the most frequently isolated bacteria (26%) in children with cOME (Group II), the incidence of S. pyogenes as a potential pathogen was only 1% (p<0.05) in Group II and the anaerobic Prevotella spp. were significantly less common (p<0.05) in children with cOME (Group II).
  
  
  CONCLUSIONS
  Potential pathogens of middle ear colonized in adenoid tissue may not be significant factor for the etiopathogenesis of cOME. Bacterial interference mechanisms may play an important role in pathogenesis of cOME because of Prevotella spp. showed statistically significant decrease children with cOME.
authors.affiliation: Department of Otorhinolaryngology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey. aalmac@kocaeli.edu.tr
authors.forename: Ahmet
authors.initials: A
authors.lastname: Almac
authors.forename: Sultan Sevik
authors.initials: SS
authors.lastname: Elicora
authors.forename: Zeki
authors.initials: Z
authors.lastname: Yumuk
authors.forename: Volkan
authors.initials: V
authors.lastname: Dundar
authors.forename: Ayse
authors.initials: A
authors.lastname: Willke
mesh_terms: D000233:Adenoidectomy / Q000379:methods; D000234:Adenoids / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D006984:Hypertrophy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D015994:Incidence; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods; D010034:Otitis Media with Effusion / Q000453:epidemiology* / Q000382:microbiology* / Q000601:surgery; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D014421:Turkey / Q000453:epidemiology