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Bacteria caused chronic otitis more often than viruses
In children with recurring or chronic otitis media, Haemophilus influenzae and Moraxella catarrhalis were the most common culprits in a group of children in the Netherlands.
Kim Stol, MD, and colleagues from the department of pediatrics at Radboud University Nijmegen Medical Centre in Nijmegen, collected 116 samples of middle ear fluids (MEFs) from children aged younger than 5 years who were scheduled for tube insertion due to chronic or recurrent episodes of otitis media (OM). The researchers used quantitative polymerase chain reaction to detect viruses and bacteria in MEF samples.
Stol and colleagues classified fluid samples into four groups: 1) 28% of fluid samples contained viruses; 2) 27% contained bacteria; 3) 27% contained both; 4) and 19% had no detectable otopathogens. Both bacterial load and species type affected cytokine levels, which were more pronounced in the pathogens containing bacteria. This association was not found in samples that had viruses. Cytokines “play a pivotal role in mediating the inflammatory response during OM.”
The researchers reported that H. influenzae was the most common bacteria (43 samples tested), followed by M. catarrhalis (32 samples tested positive). Streptococcus pneumoniae was noted in 8% of the sample.
In contrast to previous findings that indicated an association between cytokine response profiles and virus-induced acute OM, these results suggest that the MEF cytokine response is not significantly different when viruses are detected.
“These data suggest a more indirect role for virus infections in the inflammatory response, in particular for rhinovirus, during chronic OM,” Stol and colleagues wrote. “We demonstrate that the detection of the three major bacterial OM pathogens is associated with a significantly elevated inflammatory cytokine response compared to MEFs without bacteria.”
Disclosure: Dr. Stol reports no relevant financial disclosures.
