title: Microbiology of otitis media in Indigenous Australian children: review.
abstract: OBJECTIVE
  To review research addressing the polymicrobial aetiology of otitis media in Indigenous Australian children in order to identify research gaps and inform best practice in effective prevention strategies and therapeutic interventions.
  
  
  METHODS
  Literature review.
  
  
  RESULTS
  Studies of aspirated middle-ear fluid represented a minor component of the literature reviewed. Most studies relied upon specimens from middle-ear discharge or the nasopharynx. Culture-based middle-ear discharge studies have found that non-typeable Haemophilus influenzae and Streptococcus pneumoniae predominate, with Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes isolated in a lower proportion of samples. Alloiococcus otitidis was detected in a number of studies; however, its role in otitis media pathogenesis remains controversial. Nasopharyngeal colonisation is a risk factor for otitis media in Indigenous infants, and bacterial load of otopathogens in the nasopharynx can predict the ear state of Indigenous children.
  
  
  CONCLUSIONS
  Most studies have used culture-based methods and specimens from middle-ear discharge or the nasopharynx. Findings from these studies are consistent with international literature, but reliance on culture may incorrectly characterise the microbiology of this condition. Advances in genomic technologies are now providing microbiologists with the ability to analyse the entire mixed bacterial communities ('microbiomes') of samples obtained from Indigenous children with otitis media.
authors.affiliation: Child Health Division,Menzies School of Health Research,Charles Darwin University,Darwin.
authors.forename: J
authors.initials: J
authors.lastname: Jervis-Bardy
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Flinders University,Adelaide,Australia.
authors.forename: A S
authors.initials: AS
authors.lastname: Carney
authors.affiliation: Child Health Division,Menzies School of Health Research,Charles Darwin University,Darwin.
authors.forename: R
authors.initials: R
authors.lastname: Duguid
authors.affiliation: Child Health Division,Menzies School of Health Research,Charles Darwin University,Darwin.
authors.forename: A J
authors.initials: AJ
authors.lastname: Leach
mesh_terms: D001315:Australia / Q000208:ethnology; D002648:Child; D002908:Chronic Disease; D004269:DNA, Bacterial / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D004432:Ear, Middle / Q000382:microbiology; D006801:Humans; D009302:Nasopharyngeal Diseases / Q000208:ethnology; D010033:Otitis Media / Q000208:ethnology* / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods; D014777:Virus Diseases / Q000208:ethnology
chemical_list: D004269:DNA, Bacterial; D004279:DNA, Viral
keywords: Indigenous Population; Microbiology; Middle Ear; Otitis Media; Review