Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-17T16:35:26.120Z Has data issue: false hasContentIssue false

Bacteriology of otitis media with effusion

Published online by Cambridge University Press:  29 June 2007

K. B. Sriwardhana
Affiliation:
Bangor
A. J. Howard*
Affiliation:
Bangor
K. T. Dunkin
Affiliation:
Bangor
*
Dr. A. J. Howard, Gwynedd District General Hospital, Penrhosgarnedd, Bangor, Gwynedd, North Wales.

Abstract

A study was undertaken to evaluate the prevalence and antibiotic susceptibility of bacteria present in the middle ear of patients with otitis media with effusion. Middle ear effusions (MEE), nasopharyngeal and throat swabs were obtained at operation and cultured for aerobic and anaerobic bacteria. Two hundred and fifty-nine effusions were obtained from 152 subjects examined. Haemophilus influenzae was isolated from 32 (12.3 per cent) effusions. Streptococcus pneumoniae from seven (2.7 per cent), Staphylococcus aureus from seven (2.7 per cent), Branhamella catarrhalis from one (0.4 per cent)—Group A β haemolytic streptococci from one (0.4 per cent) and Staphylcoccus epidermidis from three (1.9 per cent). The occurrence of respiratory pathogens in MEE reflected their prevalence in the upper respiratory tract. Significantly fewer children who had received antibiotics prior to surgery had organisms present in the MEE. Eight and a half per cent of H. influenzae and 64 per cent of B. catarrhalis were resistant to ampicillin. The present study confirms that bacteria are present in the middle ear in a significant number of patients with otitis media with effusion.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Box, Q. T., Cleveland, R. T. and Willard, L. Y. (1961). Bacterial flora of the upper respiratory tract. American Journal of Diseases of Children, 102: 293301.Google Scholar
Cowan, S. T. (1974). Cowan and Steel's manual for the identification of medical bacteria. 2nd Edn.Cambridge University Press, Cambridge.Google Scholar
Dawson, B. and Zimmermann, K. (1952). Incidence and type distribution of capsulated H. influenzae strains. British Medical Journal, 1: 740742.Google Scholar
Draper, W. (1967). Secretory otitis media in children. A study of 540 children. Laryngoscope, 77: 636653.Google Scholar
Feigin, R. D., Shackelford, P. G., Campbel, J., Lyles, T. O., Schechter, M. and Lins, R. D. (1973). Assessment of the role of Staphylococcus epidermidis as a cause of otitis media. Paediatrics 52: 569576.Google Scholar
Friedman, I. (163). The pathology of secretory otitis media. Proceedings of the Royal Society of Medicine 56: 695699.CrossRefGoogle Scholar
Giebink, G. S., Mills, E. L., Huff, J. S., Edleman, C. K., Weber, M. L., Juhn, S. K. and Quie, P. G. (1979). Microbiology of serous and mucoid otitis media. Pediatrics, 63: 915919.Google Scholar
Harcourt, F. L. and Brown, A. K. (1953). Hydrotympanum (Secretory oitis media). Archives of Otolaryngology, 52: 1221.CrossRefGoogle Scholar
Healy, G. B. and Teele, D. W. (1977). The microbiology of chronic middle ear effusion in children. Laryngoscope, 87: 14721478.Google Scholar
Howard, A. J., Dunkin, K. T. and Millar, G. W. (1988) Nasopharyngeal carriage and antibiotic resistance of Haemophilus influenzae, in healthy children. Epidemiology and Infection, 100: 193203.CrossRefGoogle ScholarPubMed
Howard, A. J. and Williams, H. M. (1988). The prevalence of antibiotic resistance in Haemophilus influenzae in Wales. Journal of Anitmicrobial Chemotherapy, 21: 251260.Google Scholar
Kaplan, E. L. (1980). The Group ‘A’ streptococcal upper respiratory tract carrier state. An enigma. Journal of Pediatrics, 97: 337345.CrossRefGoogle Scholar
King, J. T. (1953). The condition of fluid in the middle ear. Factors influencing the prognosis in 56 children. Annals of Otology, Rhinology and Laryngology, 62: 498506.CrossRefGoogle ScholarPubMed
Kokko, E. (1974). Chronic otitis media in children. A clinical study. Acta Otolaryngologican suppl., 327: 144.Google ScholarPubMed
Lim, D. J., Lewis, D. M., Schram, J. L. and Birck, H. G. (1979). Otitis media with effusion: Cytological and microbiological correlates. Archives of Otolaryngology, 105: 404412.Google Scholar
Lim, D. J., Lewis, D. M., Schram, J. L., and Birck, H. G. (1980). Antibiotic resistant bacteria in chronic otitis media with effusion. Annals of Otology, Rhinology and Laryngology (Suppl. 89), 68: 278280.CrossRefGoogle Scholar
Liu, Y. S., Lim, D. J., Lang, R. W. and Birck, H. G. (1975). Chronic middle ear effusions—(immunological and bacteriological investigations) Archives of Otolaryngology, 101: 278286.Google Scholar
Masters, P. L., Brumfitt, W., Mendez, R. L. and Likar, M. (1958). Bacterial flora of the upper respiratory tract in Paddington families, 1952–4. British Medical Journal, 1: 12001205.CrossRefGoogle ScholarPubMed
Mcleod, D. T., Ahmad, F., Capewell, S., Croughan, M. J., Calder, M. A. and Seaton, A. (1986). Increase in bronchopulmonary infection due to Branhamella catarrhalis British Medical Journal, 293: 11031105.CrossRefGoogle Scholar
Mills, R., Uttley, A. and McIntyre, M. (1984). Relations between acute suppurative otitis media and chronic secretory otitis media; role of antibiotics. Journal of the Royal Society of Medicine. 77: 754757.CrossRefGoogle Scholar
O'Callaghan, C. H., Morris, A., Kirby, S. M. and Shingles, A. H. (1972). A novel method for detection of β-lactamase by using a chromogenic cephalosporin substrate. Antimicrobial Agents and Chemotherapy, 1: 283288.Google Scholar
Palva, T., Holopainen, E. and Karma, P. (1976). Protein and cellular pattern of glue ear secretions. Annals of Otology, Rhinology and Laryngology, 85: suppl. 25, 103109.CrossRefGoogle ScholarPubMed
Podoshin, L., Persico, M. and Fradis, M. (1978). Otitis media with effusion—a steriod and antibiotic therapeutic trial before surgery. Annals of Otology, Rhinology and Laryngology, 87: 191196.Google Scholar
Riding, K. H., Bluestone, C. D., Michaels, R. H., Cantekin, E. I., Doyle, W. J. and Poziviak, C. S. (1978). Microbiology of recurrent and Chronic Otitis Media with effusion. Journal of Pediatrics, 93: 739743.CrossRefGoogle ScholarPubMed
Robinson, J. M. (1942). Subacute catarrhal otitis media and mastoiditis with effusion. Southern Medical Journal, 35: 815824.Google Scholar
Sade, J. (1966). Pathology and pathogenesis of serous otitis media. Archives of Otolaryngology, 84: 297305.Google Scholar
Sell, S. H., Turner, D. J. and Federspal, C. F. (1973). Natural infections with Haemophilus influenzae in children. Types identified in Haemophilus influenzae (ed. Sell, H. W. and Karzon, D. T.), pp 312. Vanderbilt University Press.Google Scholar
Senturia, B. H., Gessert, C. F., Carr, C. D. and Baumann, E. S. (1958). Studies concerned with tubotympanitis. Annals of Otology, Rhinology and Laryngology, 67: 440467.CrossRefGoogle ScholarPubMed
Silverstein, H., Miller, G. F. and Linderman, R. C. (1966). Eustachian Tube dynsfunction as a cause for chronic secretory otitis in children. Laryngoscope, 76: 259273.CrossRefGoogle ScholarPubMed
Sipila, P., Ryhanen, P. and Karma, P. (1979). T. cells as marked with acid or naphyl acetate esterase staining in secretory otitis media. Acta otolaryngologica Suppl. 360: 216220.Google Scholar
Sipila, P., Jokipii, A. M. M., Jokipii, L and Karma, P. (1981). Bacteria in the middle ear and ear canal of patients with secretory otitis media and with non-inflamed ears. Acta Otolaryngologica, 92: 123130.Google Scholar
Suehs, O. W. (1952). Secretory otitis media. Laryngoscope, 62: 9981027.CrossRefGoogle ScholarPubMed
Tos, M. and Bak-Pedersen, K. (1972). The pathogenesis of chronic secretory otitis media. Archives of Otolaryngology, 95: 511521.CrossRefGoogle ScholarPubMed
Willard, C. Y. and Hansen, A. E. (1959). Bacterial flora of the nasopharynx in children: influence of respiratory infections and antimicrobial therapy. American Journal of Diseases of Children, 105: 318325.CrossRefGoogle Scholar