Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion

Kim Stol, Suzanne J. C. Verhaegh, Kees Graamans, Joost A. M. Engel, Patrick D. J. Sturm, Willem J. G. Melchers, Jacques F. Meis, Adilia Warris, John P. Hays, Peter W. M. Hermans

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVES: Otitis media (OM) is one of the most frequent diseases of childhood, with a minority of children suffering from recurrent acute otitis media (rAOM) or chronic otitis media with effusion (COME), both of which are associated with significant morbidity. We investigated whether the microbiological profiling could be used to differentiate between these two conditions.

METHODS: Children up to five years of age, with rAOM (n = 45) or COME (n = 129) and scheduled for tympanostomy tube insertion were enrolled in a prospective study between 2008 and 2009. Middle ear fluids (n = 119) and nasopharyngeal samples (n = 173) were collected during surgery for bacterial culture and PCR analysis to identify Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, and to detect 15 distinct respiratory viruses.

RESULTS: The occurrence of bacterial and viral pathogens in middle ear fluids did not significantly differ between patients suffering from rAOM and COME. In both patient cohorts, H. influenzae and rhinovirus were the predominant pathogens in the middle ear and nasopharynx. Nasopharyngeal carriage with two or three bacterial pathogens was associated with the presence of bacteria in middle ear fluid (P = 0.04). The great majority of the bacteria isolated from middle ear fluid were genetically identical to nasopharyngeal isolates from the same patient.

CONCLUSIONS: Based on these results, we propose that the common perception that rAOM is associated with recurrent episodes of microbiologically mediated AOM, whereas COME is generally a sterile inflammation, should be reconsidered.

Original languageEnglish
Pages (from-to)488-493
Number of pages6
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume77
Issue number4
Early online date29 Jan 2013
DOIs
Publication statusPublished - Apr 2013

Fingerprint

Otitis Media with Effusion
Otitis Media
Middle Ear
Haemophilus influenzae
Middle Ear Ventilation
Bacteria
Moraxella (Branhamella) catarrhalis
Rhinovirus
Nasopharynx
Streptococcus pneumoniae
Prospective Studies
Viruses
Inflammation
Morbidity
Polymerase Chain Reaction

Keywords

  • Otitis media
  • Bacteria
  • Viruses

Cite this

Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion. / Stol, Kim; Verhaegh, Suzanne J. C.; Graamans, Kees; Engel, Joost A. M.; Sturm, Patrick D. J.; Melchers, Willem J. G.; Meis, Jacques F.; Warris, Adilia; Hays, John P.; Hermans, Peter W. M.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 77, No. 4, 04.2013, p. 488-493.

Research output: Contribution to journalArticle

Stol, K, Verhaegh, SJC, Graamans, K, Engel, JAM, Sturm, PDJ, Melchers, WJG, Meis, JF, Warris, A, Hays, JP & Hermans, PWM 2013, 'Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion', International Journal of Pediatric Otorhinolaryngology, vol. 77, no. 4, pp. 488-493. https://doi.org/10.1016/j.ijporl.2012.12.016
Stol, Kim ; Verhaegh, Suzanne J. C. ; Graamans, Kees ; Engel, Joost A. M. ; Sturm, Patrick D. J. ; Melchers, Willem J. G. ; Meis, Jacques F. ; Warris, Adilia ; Hays, John P. ; Hermans, Peter W. M. / Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion. In: International Journal of Pediatric Otorhinolaryngology. 2013 ; Vol. 77, No. 4. pp. 488-493.
@article{5ee6020dc40344138bceb257815e481a,
title = "Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion",
abstract = "OBJECTIVES: Otitis media (OM) is one of the most frequent diseases of childhood, with a minority of children suffering from recurrent acute otitis media (rAOM) or chronic otitis media with effusion (COME), both of which are associated with significant morbidity. We investigated whether the microbiological profiling could be used to differentiate between these two conditions.METHODS: Children up to five years of age, with rAOM (n = 45) or COME (n = 129) and scheduled for tympanostomy tube insertion were enrolled in a prospective study between 2008 and 2009. Middle ear fluids (n = 119) and nasopharyngeal samples (n = 173) were collected during surgery for bacterial culture and PCR analysis to identify Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, and to detect 15 distinct respiratory viruses.RESULTS: The occurrence of bacterial and viral pathogens in middle ear fluids did not significantly differ between patients suffering from rAOM and COME. In both patient cohorts, H. influenzae and rhinovirus were the predominant pathogens in the middle ear and nasopharynx. Nasopharyngeal carriage with two or three bacterial pathogens was associated with the presence of bacteria in middle ear fluid (P = 0.04). The great majority of the bacteria isolated from middle ear fluid were genetically identical to nasopharyngeal isolates from the same patient.CONCLUSIONS: Based on these results, we propose that the common perception that rAOM is associated with recurrent episodes of microbiologically mediated AOM, whereas COME is generally a sterile inflammation, should be reconsidered.",
keywords = "Otitis media, Bacteria, Viruses",
author = "Kim Stol and Verhaegh, {Suzanne J. C.} and Kees Graamans and Engel, {Joost A. M.} and Sturm, {Patrick D. J.} and Melchers, {Willem J. G.} and Meis, {Jacques F.} and Adilia Warris and Hays, {John P.} and Hermans, {Peter W. M.}",
note = "The authors would like to thank all of the children and parents who participated in this study. We are grateful to the staff of the departments ORL and Medical Microbiology of the Canisius Wilhelmina Hospital and the Radboud University Nijmegen Medical Centre for their commitment to the study, in particular M. de Bruyn (CWZ), C. Bartels and K. Teuwen (RUNMC) for excellent coordination. E.R. Simonetti and C. de Jongh-van der Gaast are acknowledged for technical assistance. We thank H.J. Bootsma and S. van Selm for critical reading of the manuscript. This project was funded by a European Union Sixth Framework Program (Project Title: OMVac. Project No. 037653).",
year = "2013",
month = "4",
doi = "10.1016/j.ijporl.2012.12.016",
language = "English",
volume = "77",
pages = "488--493",
journal = "International Journal of Pediatric Otorhinolaryngology",
issn = "0165-5876",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

TY - JOUR

T1 - Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion

AU - Stol, Kim

AU - Verhaegh, Suzanne J. C.

AU - Graamans, Kees

AU - Engel, Joost A. M.

AU - Sturm, Patrick D. J.

AU - Melchers, Willem J. G.

AU - Meis, Jacques F.

AU - Warris, Adilia

AU - Hays, John P.

AU - Hermans, Peter W. M.

N1 - The authors would like to thank all of the children and parents who participated in this study. We are grateful to the staff of the departments ORL and Medical Microbiology of the Canisius Wilhelmina Hospital and the Radboud University Nijmegen Medical Centre for their commitment to the study, in particular M. de Bruyn (CWZ), C. Bartels and K. Teuwen (RUNMC) for excellent coordination. E.R. Simonetti and C. de Jongh-van der Gaast are acknowledged for technical assistance. We thank H.J. Bootsma and S. van Selm for critical reading of the manuscript. This project was funded by a European Union Sixth Framework Program (Project Title: OMVac. Project No. 037653).

PY - 2013/4

Y1 - 2013/4

N2 - OBJECTIVES: Otitis media (OM) is one of the most frequent diseases of childhood, with a minority of children suffering from recurrent acute otitis media (rAOM) or chronic otitis media with effusion (COME), both of which are associated with significant morbidity. We investigated whether the microbiological profiling could be used to differentiate between these two conditions.METHODS: Children up to five years of age, with rAOM (n = 45) or COME (n = 129) and scheduled for tympanostomy tube insertion were enrolled in a prospective study between 2008 and 2009. Middle ear fluids (n = 119) and nasopharyngeal samples (n = 173) were collected during surgery for bacterial culture and PCR analysis to identify Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, and to detect 15 distinct respiratory viruses.RESULTS: The occurrence of bacterial and viral pathogens in middle ear fluids did not significantly differ between patients suffering from rAOM and COME. In both patient cohorts, H. influenzae and rhinovirus were the predominant pathogens in the middle ear and nasopharynx. Nasopharyngeal carriage with two or three bacterial pathogens was associated with the presence of bacteria in middle ear fluid (P = 0.04). The great majority of the bacteria isolated from middle ear fluid were genetically identical to nasopharyngeal isolates from the same patient.CONCLUSIONS: Based on these results, we propose that the common perception that rAOM is associated with recurrent episodes of microbiologically mediated AOM, whereas COME is generally a sterile inflammation, should be reconsidered.

AB - OBJECTIVES: Otitis media (OM) is one of the most frequent diseases of childhood, with a minority of children suffering from recurrent acute otitis media (rAOM) or chronic otitis media with effusion (COME), both of which are associated with significant morbidity. We investigated whether the microbiological profiling could be used to differentiate between these two conditions.METHODS: Children up to five years of age, with rAOM (n = 45) or COME (n = 129) and scheduled for tympanostomy tube insertion were enrolled in a prospective study between 2008 and 2009. Middle ear fluids (n = 119) and nasopharyngeal samples (n = 173) were collected during surgery for bacterial culture and PCR analysis to identify Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, and to detect 15 distinct respiratory viruses.RESULTS: The occurrence of bacterial and viral pathogens in middle ear fluids did not significantly differ between patients suffering from rAOM and COME. In both patient cohorts, H. influenzae and rhinovirus were the predominant pathogens in the middle ear and nasopharynx. Nasopharyngeal carriage with two or three bacterial pathogens was associated with the presence of bacteria in middle ear fluid (P = 0.04). The great majority of the bacteria isolated from middle ear fluid were genetically identical to nasopharyngeal isolates from the same patient.CONCLUSIONS: Based on these results, we propose that the common perception that rAOM is associated with recurrent episodes of microbiologically mediated AOM, whereas COME is generally a sterile inflammation, should be reconsidered.

KW - Otitis media

KW - Bacteria

KW - Viruses

U2 - 10.1016/j.ijporl.2012.12.016

DO - 10.1016/j.ijporl.2012.12.016

M3 - Article

VL - 77

SP - 488

EP - 493

JO - International Journal of Pediatric Otorhinolaryngology

JF - International Journal of Pediatric Otorhinolaryngology

SN - 0165-5876

IS - 4

ER -