Disparate cultures of middle ear fluids. Results from children with bilateral otitis media.

Cultures of middle ear fluids (MEFs) are needed to determine both efficacy of antibiotics and vaccines, and microbiologic outcome of otitis media (OM). We reviewed data on 221 children, aged 2 months to 12 years; 122 had acute otitis media (AOM), 99 had asymptomatic MEF. We included only Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, and Staphylococcus aureus as pathogens. Of children with AOM, MEF was sterile or contained nonpathogens in both ears in 51, and one or more pathogens in 71. Of these 71, 40 had the same pathogen or pathogens in both ears; 25 patients had a pathogen in one ear and sterile fluid or only nonpathogens in the other; four patients had a different pathogen in each ear; and two patients had two pathogens in one ear and only one in the other. Of those with asymptomatic MEFs, in 80 the effusion was sterile or contained only nonpathogens in both ears, and in 19 contained one or more pathogens. Of these 19, ten had the same pathogen isolated from both ears; nine had a pathogen in one ear and sterile fluid or only nonpathogens in the other. Thus, in 31 children with AOM and nine with asymptomatic MEFs, results of cultures of MEF were different.