title: Otopathogens Detected in Middle Ear Fluid Obtained during Tympanostomy Tube Insertion: Contrasting Purulent and Non-Purulent Effusions.
abstract: Otitis media is a prominent disease among children. Previous literature indicates that otitis media is a polymicrobial disease, with Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis and Moraxella catarrhalis being the most commonly associated bacterial pathogens. Recent literature suggests that introduction of pneumococcal conjugate vaccines has had an effect on the etiology of otitis media. Using a multiplex PCR procedure, we sought to investigate the presence of the aforementioned bacterial pathogens in middle ear fluid collected from children undergoing routine tympanostomy tube placement at Wake Forest Baptist Medical Center during the period between January 2011 and March 2014. In purulent effusions, one or more bacterial organisms were detected in ~90% of samples. Most often the presence of H. influenzae alone was detected in purulent effusions (32%; 10 of 31). In non-purulent effusions, the most prevalent organism detected was A. otitidis (26%; 63 of 245). Half of the non-purulent effusions had none of these otopathogens detected. In purulent and non-purulent effusions, the overall presence of S. pneumoniae was lower (19%; 6 of 31, and 4%; 9 of 245, respectively) than that of the other pathogens being identified. The ratio of the percentage of each otopathogen identified in purulent vs. non-purulent effusions was >1 for the classic otopathogens but not for A. otitidis.
authors.affiliation: Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holder
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Kirse
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Adele K
authors.initials: AK
authors.lastname: Evans
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Whigham
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Peters
authors.affiliation: Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America; Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Poehling
authors.affiliation: Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: William E
authors.initials: WE
authors.lastname: Swords
authors.affiliation: Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America; Department of Microbiology and Immunology, Ross University School of Medicine, Roseau, Dominica, West Indies.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Reid
mesh_terms: D001424:Bacterial Infections / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D056568:Carnobacteriaceae / Q000254:growth & development / Q000302:isolation & purification*; D002675:Child, Preschool; D004432:Ear, Middle / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006193:Haemophilus influenzae / Q000254:growth & development / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D001936:Moraxella catarrhalis / Q000254:growth & development / Q000302:isolation & purification*; D010034:Otitis Media with Effusion / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000254:growth & development / Q000302:isolation & purification*; D013492:Suppuration