title: Nasopharyngeal biofilm-producing otopathogens in children with nonsevere recurrent acute otitis media.
abstract: OBJECTIVE
  Bacterial biofilms have been detected in biopsies of the adenoid and middle ear mucosa of otitis-prone children and children with chronic middle otitis media. However, the invasiveness of biopsy makes it unsuitable for routine clinical practice, especially in pediatrics. This study aimed to investigate nasopharyngeal biofilm-producing otopathogens (BPOs) of nasopharyngeal swabs (NPS) in children with a history of nonsevere recurrent acute otitis media (RAOM) and healthy controls.
  
  
  METHODS
  A cross-sectional study with planned data collection.
  
  
  METHODS
  University of Milan.
  
  
  METHODS
  Transoral NPS were taken from infants and children aged 10 months to 11 years with nonsevere RAOM or healthy controls without adenoid hypertrophy. Nasopharyngeal colonization by otopathogens was assessed by means of microbiological cultures and standard bacterial identification, as well as nasopharyngeal BPOs by means of spectrophotometric analysis.
  
  
  RESULTS
  The study involved 113 children (56.6% males; median age 40 months; range, 10-132 months): 58 with a history of nonsevere RAOM (51.3%) and 55 controls (48.7%). Otopathogens were significantly more frequently detected in the RAOM group (24/58, 41.4%) than in controls (8/55, 14.5%; P = .003); the main pathogens were respectively Haemophilus influenzae (12/24, 50.0%) and Streptococcus pyogenes (3/8, 37.5%). Nasopharyngeal BPOs were more frequently isolated in the RAOM group (17/58, 29.3%) than in controls (6/55, 10.9%; P = .02). H influenzae (12/17, 70.6%) was confirmed as the main pathogen in the RAOM group.
  
  
  CONCLUSIONS
  The presence of nasopharyngeal BPOs is an important factor favoring RAOM; it is therefore useful investigating biofilms even in children with nonsevere recurrences of AOM without adenoid hypertrophy.
authors.affiliation: Department of Specialistic Surgical Sciences, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy. sara.torretta@policlinico.mi.it
authors.forename: Sara
authors.initials: S
authors.lastname: Torretta
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
authors.forename: Elena
authors.initials: E
authors.lastname: Baggi
authors.forename: Elena
authors.initials: E
authors.lastname: De Vecchi
authors.forename: Werner
authors.initials: W
authors.lastname: Garavello
authors.forename: Erica
authors.initials: E
authors.lastname: Nazzari
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pignataro
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
mesh_terms: D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D018441:Biofilms; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006193:Haemophilus influenzae; D006801:Humans; D007223:Infant; D008297:Male; D001936:Moraxella catarrhalis; D009305:Nasopharynx / Q000382:microbiology*; D010033:Otitis Media / Q000175:diagnosis* / Q000382:microbiology*; D012008:Recurrence; D013053:Spectrophotometry; D013296:Streptococcus pneumoniae; D013297:Streptococcus pyogenes