Paula Yocum

Aerobic and anaerobicbacteriologic features of serous otitis media in children

Aspirates of serous ear fluids from 57 children were examined for aerobic and anaerobicbacteria. Bacterial growth was noted in 23 patients (40 per cent). Aerobic organisms only were recovered in 13 aspirates (57 per cent of the culture-positive aspirates); anaerobic bacteria in four (17 per cent); and mixed aerobic and anaerobic bacteria in six (26 per cent). A total of 45 bacterial isolates were recovered, accounting for 2.0 isolates per specimen (1.4 aerobes and 0.6 anaerobe). There were a total of 31 aerobic isolates, including Hemophilus influenzae (eight isolates), Staphylococcus aureus and Streptococcus pneumoniae (five of each), and Staphylococcus epidermidis and alpha-hemolytic streptococcus (four of each). Fourteen anaerobes were recovered, including anaerobic gram-positive cocci and Bacterdides melaninogenicus (five isolates each) and Propionibacterium acnes (three isolates)

Quantitative Bacterial Cultures and Beta-Lactamase Activity in Chronic Suppurative Otitis Media

Aspiration of the exudate through open perforation was performed in 54 children with chronic suppurative otitis media. Eighty aerobic and 81 anaerobic isolates were recovered. Aerobic bacteria only were involved in 20 patients (37%), and anaerobic organisms only in seven (13%). Mixed aerobic and anaerobic isolates were recovered from 27 patients (50%). The most common bacteria isolated were anaerobic gram-positive cocci, Bacteroides melaninogenicus group, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus. There were 45 β-lactamase–producing bacteria (BLPB), 30 aerobes, and 15 anaerobes recovered from 38 patients (70%). β-Lactamase activity was detected in 30 of the 38 ear aspirates (79%) that contained BLPB. All but one of these organisms were in excess of 104 colony-forming units/mL. The detection of β-lactamase activity in the ear aspirates provides evidence of the role of BLPB in the failure of penicillin therapy to eradicate chronic ear infection.

Comparison of the microbiology of group A and non-group A streptococcal tonsillitis.

We studied the microbial flora of tonsils removed from 20 children who suffered from recurrent group A β-hemolytic streptococcal (GABHS) tonsillitis and 20 who had tonsillar hypertrophy following recurrent non-GABHS tonsillitis. Similar polymicrobial aerobic and anaerobic flora were recovered from the cores of the tonsils in each group. β-Lactamase-producing bacteria (BLPB) were recovered more often in the group with GABHS. This difference was due mostly to the lower incidence of β-lactamase-producing strains of Branhamella catarrhalis and Bacteroides sp in hypertrophic tonsils following non-GABHS tonsillitis. β-Lactamase-producing Staphylococcus aureus was found with equal frequency in both groups. These findings demonstrate that although BLPB are recovered more often in recurrently inflamed tonsils following GABHS infection, BLPB also can be found in hypertrophic tonsils following non-GABHS tonsillitis.

Immune Response to Fusobacterium Nucleatum and Prevotella Intermedia in Patients with Chronic Maxillary Sinusitis

Our objective was to study the immune response to 2 anaerobic bacteria in patients with chronic maxillary sinusitis. Immunoglobulin G class antibody titers to Fusobacterium nucleatum and Prevotella intermedia were measured by enzyme-linked immunosorbent assay. Serum levels in the patients were determined on the day sinus aspiration for culture was done, and 75 to 90 days later, after completion of antimicrobial therapy, Prevotella intermedia was isolated from 16 aspirates, and F nucleatum from 12. Median antibody levels at day 1 for F nucleatum and P intermedia were significantly higher in patients whose serum aspirates harbored these organisms than at days 75 to 90 in those who were cured (p < .05). However, the levels stayed elevated in the 5 patients who did not improve. The elevated antibody levels to F nucleatum and P intermedia, known oral pathogens, suggest a potential pathogenic role for these organisms in chronic maxillary sinusitis.

Aerobic and anaerobic bacteriology of otorrhea associated with tympanostomy tubes in children.

The microbiology of in 55 ear aspirates obtained from 34 children with chronic otorrhea was studied. Aspiration of the middle ear exudate was done immediately following removal of tympanostomy tube (TT). The middle ear aspirates and swab specimens of the external auditory canals were cultured for aerobic and anaerobic bacteria. Sixty-five isolates were recovered only from the middle ears, 73 only from the external ear canals, and 73 were present at both sites. Analysis of the 138 middle ear isolates demonstrated the recovery of aerobic bacteria only in 28 patients (50%), anaerobes only in seven (13%), and both aerobes and anaerobes in 20 (36%). There were 77 aerobic and 61 anaerobic isolates. Commonly recovered aerobes were Pseudomonas aeruginosa (17 isolates), Staphylococcus aureus (11), Proteus sp. (7), Moraxella catarrhalis (6), Klebsiella pneumoniae (5) and non-typable Haemophilus influenzae (5). Commonly isolated anaerobes were Peptostreptococcus sp. (25 isolates), Prevotella sp. (10), Bacteroides sp. (8) and Fusobacterium sp. (6). Pseudomonas aeruginosa and S. aureus were more often isolated in children older then 6 years. These findings demonstrate the polymicrobial bacteriology of TT-related otorrhea in children. Specimens collected from the external auditory canals can be misleading. Reliable information can be obtained from the ear exudes when collected through the TT or through the open perforation after their removal.

Microbiology of serous otitis media in children: correlation with age and length of effusion.

The purpose of this study was to correlate the microbiology of serous otitis media in children with the duration of the condition and the patients age. Aspirates of serous ear fluids from 114 children were examined for aerobic and anaerobic bacteria. Bacterial growth was noted in 47 patients (41%). Aerobic organisms only were recovered in 27 aspirates (57% of the culture-positive aspirates); anaerobic bacteria only in 7 (15%); and mixed aerobic and anaerobic bacteria in 13 (28%). A total of 83 bacterial isolates were recovered, accounting for 1.8 isolates per specimen (1.2 aerobes and 0.6 anaerobe). There were a total of 57 aerobic isolates, including Haemophilus influenzae (15 isolates), Streptococcus pneumoniae (13), and Staphylococcus sp (12). Twenty-six anaerobes were recovered, including anaerobic gram-positive cocci (10), Prevotella spp (8), and Propionibacterium acnes (4). The rate of positive cultures (20 of 36; 56%) was higher in patients younger than 2 years of age than in those older than 2 years of age (27 of 78; 35%). Streptococcus pneumoniae and H influenzae were more often isolated in children younger than 2 years of age and those with effusion for 3 to 5 months, whereas anaerobes were recovered more often in those older than 2 years of age and those with effusion for 6 to 13 months. These data illustrate the effects of the length of effusion and age on the recovery of aerobic and anaerobic bacteria in serous otitis media.