OBJECTIVE: For Indigenous Australian children living in remote communities, onset of otitis media commences within weeks of birth and is associated with early nasopharyngeal colonisation with multiple respiratory bacterial pathogens: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The high prevalence of eardrum perforation and the failure of standard therapies to cure or prevent OM in this population require urgent attention. The objective of this study was to measure the changes in nasopharyngeal bacterial flora between birth and first episode of otitis media. METHODS: For 10 randomly selected Indigenous children with early onset otitis media, S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus, and total bacterial load were enumerated in serial nasopharyngeal swabs using real-time quantitative PCR. RESULTS: Between 0 and 3 weeks of age, all 10 infants had bilaterally normal ears. At 3-6 weeks of age, seven of eight infants examined had otitis media. By 6-13 weeks of age, all 10 infants had otitis media. The relative density of respiratory pathogens among total nasopharyngeal flora increased significantly with onset of otitis media, and the majority of children became colonised with the three respiratory pathogens. There was no association between OM onset and S. aureus load. CONCLUSIONS: Onset of otitis media between 3 and 6 weeks of life was associated with a significant increase in all major bacterial OM pathogens (S. pneumoniae, H. influenzae, M. catarrhalis), as well as total bacterial load in the nasopharynx. Interventions to prevent acquisition of multiple OM pathogens in the first weeks of life are needed.
OBJECTIVE: For Indigenous Australian children living in remote communities, onset of otitis media commences within weeks of birth and is associated with early nasopharyngeal colonisation with multiple respiratory bacterial pathogens: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The high prevalence of eardrum perforation and the failure of standard therapies to cure or prevent OM in this population require urgent attention. The objective of this study was to measure the changes in nasopharyngeal bacterial flora between birth and first episode of otitis media. METHODS: For 10 randomly selected Indigenous children with early onset otitis media, S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus, and total bacterial load were enumerated in serial nasopharyngeal swabs using real-time quantitative PCR. RESULTS: Between 0 and 3 weeks of age, all 10 infants had bilaterally normal ears. At 3-6 weeks of age, seven of eight infants examined had otitis media. By 6-13 weeks of age, all 10 infants had otitis media. The relative density of respiratory pathogens among total nasopharyngeal flora increased significantly with onset of otitis media, and the majority of children became colonised with the three respiratory pathogens. There was no association between OM onset and S. aureus load. CONCLUSIONS: Onset of otitis media between 3 and 6 weeks of life was associated with a significant increase in all major bacterial OM pathogens (S. pneumoniae, H. influenzae, M. catarrhalis), as well as total bacterial load in the nasopharynx. Interventions to prevent acquisition of multiple OM pathogens in the first weeks of life are needed.
Authors: Timothy F Murphy; Tasnee Chonmaitree; Stephen Barenkamp; Jennelle Kyd; Johanna Nokso-Koivisto; Janak A Patel; Terho Heikkinen; Noboru Yamanaka; Pearay Ogra; W Edward Swords; Tania Sih; Melinda M Pettigrew Journal: Otolaryngol Head Neck Surg Date: 2013-04 Impact factor: 3.497
Authors: R Marsh; H Smith-Vaughan; K M Hare; M Binks; F Kong; J Warning; G L Gilbert; P Morris; A J Leach Journal: J Clin Microbiol Date: 2009-12-30 Impact factor: 5.948
Authors: M John; E M Dunne; P V Licciardi; C Satzke; O Wijburg; R M Robins-Browne; S O'Leary Journal: Eur J Clin Microbiol Infect Dis Date: 2013-03-20 Impact factor: 3.267
Authors: Ruth B Thornton; Lea-Ann S Kirkham; Karli J Corscadden; Selma P Wiertsema; Angela Fuery; B Jan Jones; Harvey L Coates; Shyan Vijayasekaran; Guicheng Zhang; Anthony Keil; Peter C Richmond Journal: Clin Vaccine Immunol Date: 2017-04-05