Is attachment of bacteria to the epithelial cells of the nasopharynx the key to otitis media?

Epithelial cells from the nasopharynx of 42 young healthy individuals were obtained by swabbing. The filtered cellular mixture was stained with acridine orange and bacteria attached to the epithelial cells were counted using a fluorescence microscope. Simultaneously qualitative and quantitative bacteriological analyses were performed. Young individuals (less than 2 years) had significantly more attached bacteria than older ones (11-15 years) (P = 0.0001). The presence of middle ear pathogens in the nasopharynx of young children was significantly more prominent than in the older age groups (P less than 0.001). Attachment of middle ear pathogens to nasopharyngeal epithelial cells of young individuals may predispose to otitis media.