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Tamir SO, Bialasiewicz S, Brennan-Jones CG, Der C, Kariv L, Macharia I, Marsh RL, Seguya A, Thornton R. ISOM 2023 research Panel 4 - Diagnostics and microbiology of otitis media. Int J Pediatr Otorhinolaryngol 2023; 174:111741. [PMID: 37788516 DOI: 10.1016/j.ijporl.2023.111741] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVES To identify and review key research advances from the literature published between 2019 and 2023 on the diagnosis and microbiology of otitis media (OM) including acute otitis media (AOM), recurrent AOM (rAOM), otitis media with effusion (OME), chronic suppurative otitis media (CSOM) and AOM complications (mastoiditis). DATA SOURCES PubMed database of the National Library of Medicine. REVIEW METHODS All relevant original articles published in Medline in English between July 2019 and February 2023 were identified. Studies that were reviews, case studies, relating to OM complications (other than mastoiditis), and studies focusing on guideline adherence, and consensus statements were excluded. Members of the panel drafted the report based on these search results. MAIN FINDINGS For the diagnosis section, 2294 unique records screened, 55 were eligible for inclusion. For the microbiology section 705 unique records were screened and 137 articles were eligible for inclusion. The main themes that arose in OM diagnosis were the need to incorporate multiple modalities including video-otoscopy, tympanometry, telemedicine and artificial intelligence for accurate diagnoses in all diagnostic settings. Further to this, was the use of new, cheap, readily available tools which may improve access in rural and lowmiddle income (LMIC) settings. For OM aetiology, PCR remains the most sensitive method for detecting middle ear pathogens with microbiome analysis still largely restricted to research use. The global pandemic response reduced rates of OM in children, but post-pandemic shifts should be monitored. IMPLICATION FOR PRACTICE AND FUTURE RESEARCH Cheap, easy to use multi-technique assessments combined with artificial intelligence and/or telemedicine should be integrated into future practice to improve diagnosis and treatment pathways in OM diagnosis. Longitudinal studies investigating the in-vivo process of OM development, timings and in-depth interactions between the triad of bacteria, viruses and the host immune response are still required. Standardized methods of collection and analysis for microbiome studies to enable inter-study comparisons are required. There is a need to target underlying biofilms if going to effectively prevent rAOM and OME and possibly enhance ventilation tube retention.
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Affiliation(s)
- Sharon Ovnat Tamir
- Department of Otolaryngology-Head and Neck Surgery, Sasmon Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University of the Negev, Israel.
| | - Seweryn Bialasiewicz
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Christopher G Brennan-Jones
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Carolina Der
- Facultad de Medicina, Universidad Del Desarrollo, Dr Luis Calvo Mackenna Hospital, Santiago, Chile
| | - Liron Kariv
- Hearing, Speech and Language Institute, Sasmon Assuta Ashdod University Hospital, Israel
| | - Ian Macharia
- Kenyatta University Teaching, Referral & Research Hospital, Kenya
| | - Robyn L Marsh
- Menzies School of Health Research, Darwin, Australia; School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Amina Seguya
- Department of Otolaryngology - Head and Neck Surgery, Mulago National Referral Hospital, Kampala, Uganda
| | - Ruth Thornton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; Centre for Child Health Research, University of Western Australia, Perth, Australia
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Biofilm-Forming Bacteria Implicated in Complex Otitis Media in Children in the Post-Heptavalent Pneumococcal Conjugate Vaccine (PCV7) Era. Microorganisms 2023; 11:microorganisms11030545. [PMID: 36985119 PMCID: PMC10056165 DOI: 10.3390/microorganisms11030545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Background: Chronic media with effusion (COME) and recurrent acute otitis media (RAOM) are closely related clinical entities that affect childhood. The aims of the study were to investigate the microbiological profile of otitis-prone children in the post-PCV7 era and, to examine the biofilm-forming ability in association with clinical history and outcome during a two-year post-operative follow-up. Methods: In this prospective study, pathogens from patients with COME and RAOM were isolated and studied in vitro for their biofilm-forming ability. The minimum inhibitory concentrations (MIC) of both the planktonic and the sessile forms were compared. The outcome of the therapeutic method used in each case and patient history were correlated with the pathogens and their ability to form biofilms. Results: Haemophilus influenzae was the leading pathogen (35% in COME and 40% in RAOM), and Streptococcus pneumoniae ranked second (12% in COME and 24% in RAOM). Polymicrobial infections were identified in 5% of COME and 19% of RAOM cases. Of the isolated otopathogens, 94% were positive for biofilm formation. Conclusions: This is the first Greek research studying biofilm formation in complex otitis media-prone children population in the post-PCV7 era. High rates of polymicrobial infections, along with treatment failure in biofilms, may explain the lack of antimicrobial efficacy in otitis-prone children.
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Shah MZ, Mustafa G, Iqbal M, Qasim M, Abbas K, Umair M, Baig HMA. Prevalence of Gram positive bacteria in the affected individuals of Otitis media with effusion from the indigenous population of Southern Punjab, Pakistan: first report. BRAZ J BIOL 2023; 84:e267874. [PMID: 36722679 DOI: 10.1590/1519-6984.267874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/23/2022] [Indexed: 02/02/2023] Open
Abstract
Otitis media with effusion (OME) is a type of otitis media (OM) characterized by the presence of fluid behind intact tympanic membrane and is one of the most common diseases of early childhood. It is an infectious disease associated with the presence of many pathogenic bacteria in the middle ear of affected individuals. This study was aimed to determine the prevalence of Gram-positive bacteria from the middle ear of OME patients in the population of Southern Punjab, Pakistan. The incidence of OME under comprehensive healthcare setting was investigated in patients who consulted at the department of ear, throat and nose, Bahawal Victoria Hospital (BVH), Bahawalpur, from December, 2019 to May, 2021. Ear swabs were taken from affected and normal individuals. After culturing bacteria from the ear swabs, microscopic analysis and biochemical tests were performed to characterize the cultured Gram-positive bacteria. Out of 352 patients examined, 109 (30.9%) patients had OME. Age of the participants ranged from 14 to 50 years; individuals between the ages of 14 and 22 years had the highest infection rates, while individuals between 40 and 50 years had the lowest rate of infection. Tympanic membrane perforation, fever, cough, sore throat, ear pain and hearing problem showed association with symptoms of OME. Microscopic analysis and biochemical characterization showed the presence of streptococci and staphylococci in all the studied samples. The most frequently isolated bacteria were Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus with percentage of 53.3%, 20% and 13.3% respectively. Enterococcus faecalis (6.6%) and Staphylococcus epidermidis (6.6%) were also identified in the studied samples. This study will help in the better medical administration of OME affected individuals.
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Affiliation(s)
- M Z Shah
- The Islamia University of Bahawalpur, Institute of Biochemistry, Biotechnology and Bioinformatics, Bahawalpur, Pakistan
| | - G Mustafa
- The Islamia University of Bahawalpur, Institute of Biochemistry, Biotechnology and Bioinformatics, Bahawalpur, Pakistan
| | - M Iqbal
- The Islamia University of Bahawalpur, Institute of Biochemistry, Biotechnology and Bioinformatics, Bahawalpur, Pakistan
| | - M Qasim
- Government College University, Department of Bioinformatics & Biotechnology, Faisalabad, Pakistan
| | - K Abbas
- THQ Hospital, Ahmadpur East, Distt. Bahawalpur, Pakistan
| | - M Umair
- The Islamia University of Bahawalpur, Institute of Biochemistry, Biotechnology and Bioinformatics, Bahawalpur, Pakistan
| | - H M A Baig
- The Islamia University of Bahawalpur, Institute of Biochemistry, Biotechnology and Bioinformatics, Bahawalpur, Pakistan
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Chen W, Yin G, Chen Y, Wang L, Wang Y, Zhao C, Wang W, Ye J. Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy. Front Pediatr 2023; 11:1098067. [PMID: 36911018 PMCID: PMC9992982 DOI: 10.3389/fped.2023.1098067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
Objective Adenoid hypertrophy (AH) and otitis media with effusion (OME) are common pediatric otolaryngological diseases and often occur concurrently. The purpose of this study was to comprehensively analyze the factors that influence the occurrence of OME pediatric patients with AH. Methods Patients younger than 12 years with AH, who were hospitalized for treatment at Beijing Tsinghua Changgung Hospital in Beijing, China, between March 2018 and February 2022 were enrolled. The patients were divided into an AH group and an AH + OME group based on the presence of OME. The authors collected the following clinical data for univariable analysis: sex; age; body mass index (BMI); comorbid nasal congestion/rhinorrhea, recurrent tonsillitis, or allergic rhinitis (AR); adenoid and tonsil grade; tonsillar hypertrophy; food/drug allergy; history of adenoidectomy and congenital diseases; breastfeeding status; preterm birth; exposure to environmental tobacco smoke (ETS); family history of adenotonsillectomy, otitis media, and AR; main data of polysomnography and oropharyngeal conditional pathogen culture data of some patients. Univariate analysis was performed as a basis for logistic regression analysis. Results A total of 511 children (329 boys and 182 girls) were included, their mean age was 5.37 ± 2.10 years. Of them, 407 (79.6%) were in the AH group and 104 (20.4%) in the AH + OME group. Univariate analysis revealed statistically significant differences in age, BMI, adenoid grade, AR, breastfeeding status, and ETS exposure between the two groups. Multivariate stepwise logistic regression analysis showed that age, adenoid grade, AR, breastfeeding status, and ETS influenced the occurrence of OME in pediatric patients with AH. The risk of OME decreased with increasing age. High adenoid grade, ETS exposure, and comorbid AR were risk factors for OME in pediatric patients with AH, but breastfeeding was a protective factor. The final analytical results of the oropharyngeal conditional pathogen culture data showed that Streptococcus pneumoniae positivity was associated with OME in AH. Conclusion The pathogenesis of AH with OME is complex. Young age, high adenoid grade, ETS exposure, non-breastfed status, comorbid AR, and the presence of S. pneumoniae in the oropharynx are risk factors for OME in pediatric patients with AH.
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Affiliation(s)
- Wenjing Chen
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Guoping Yin
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yijing Chen
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lijun Wang
- Department of Clinical Laboratory, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yingying Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Chunmei Zhao
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wan Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jingying Ye
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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邓 文, 张 景, 李 平, 周 俊, 姚 振, 叶 小. Co-carriage of Streptococcus pneumoniae and Moraxella catarrhalis among preschool children and its influencing factors. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:874-880. [PMID: 36036125 PMCID: PMC9425867 DOI: 10.7499/j.issn.1008-8830.2204163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To investigate the carriage status of Streptococcus pneumoniae (S.pneumoniae) and Moraxella catarrhalis (M. catarrhalis) in preschool children and the influencing factors for the carriage status. METHODS The stratified cluster sampling method was used to select 2 031 healthy children from seven kindergartens in Shunde District of Foshan in Guangdong, China. Nasal swabs were collected from all children for the isolation and identification of S. pneumoniae and M. catarrhalis. The carriage status of S. pneumoniae and M. catarrhalis was analyzed in terms of its association with demographic features and hospital- and community-related factors. RESULTS The carriage rates of S. pneumoniae and M. catarrhalis were 21.81% and 52.44%, respectively among the children. The co-carriage rate of S. pneumoniae and M. catarrhalis was 14.87%. The correspondence analysis showed that the factors such as lower grade, non-local registered residence, living in rural areas, small living area, history of respiratory tract infection but no history of antibiotic use, allergic skin diseases, and no hospital-related exposure history were significantly associated with the co-carriage of S. pneumoniae and M. catarrhalis among the children (P<0.05). CONCLUSIONS Co-carriage of S. pneumoniae and M. catarrhalis can be observed in preschool children. Young age, poor living environment, a history of respiratory tract infection but no history of antibiotic use, allergic skin diseases, and no hospital-related exposure history are important risk factors for the co-carriage of S. pneumoniae and M. catarrhalis in preschool children.
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Wang Y, Liu A, Fu M, Guo J, Wang L, Zuo X, Ma F. Establishment and Clinical Application of a RPA-LFS Assay for Detection of Capsulated and Non-Capsulated Haemophilus influenzae. Front Cell Infect Microbiol 2022; 12:878813. [PMID: 35531333 PMCID: PMC9068959 DOI: 10.3389/fcimb.2022.878813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
A recombinase polymerase amplification-lateral flow strip assay was established for detection of the outer membrane protein P6 (omp6) and the capsule encoding gene bexA of Haemophilus influenzae and the detection limit, sensitivity, and specificity were determined. Specific primers and probes were designed based on the published nucleotide sequences of omp6 and bexA. The minimum detection limit was determined with standard strains and the practical applicability of the RPA-LFS assay was assessed by detection of 209 clinical samples. The results confirmed that the RPA-LFS assay was both specific and sensitive for the detection of capsulated and non-capsulated H. influenzae with a detection limit of 1 CFU/µL. The detection rate of the 209 clinical samples was 97.1%, while the detection rate of capsulated H. influenzae was 63.2%. The detection results were consistent with the traditional culture method and dual polymerase chain reaction (PCR), confirming the applicability of the RPA-LFS assay.
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Affiliation(s)
- Yan Wang
- Department of Medicine Laboratory, Department of Cardiac Function Examination, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Aibo Liu
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Mei Fu
- Department of Medicine Laboratory, Department of Cardiac Function Examination, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Jingjing Guo
- Department of Medicine Laboratory, Xuzhou Central Hospital, Xuzhou, China
| | - Lei Wang
- Department of Medicine Laboratory, Department of Cardiac Function Examination, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
- *Correspondence: Lei Wang, ; Xiaohua Zuo, ; Fenfen Ma,
| | - Xiaohua Zuo
- Department of Pain Management, The Affiliated Huai’an Hospital of Xuzhou Medical University and The Second People’s Hospital of Huai’an, Huai’an, China
- *Correspondence: Lei Wang, ; Xiaohua Zuo, ; Fenfen Ma,
| | - Fenfen Ma
- Department of Cardiac Function Examination, The Second People’s Hospital of Lianyungang, Lianyungang City, China
- *Correspondence: Lei Wang, ; Xiaohua Zuo, ; Fenfen Ma,
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Triacca A, Pitzanti G, Mathew E, Conti B, Dorati R, Lamprou DA. Stereolithography 3D printed implants: A preliminary investigation as potential local drug delivery systems to the ear. Int J Pharm 2022; 616:121529. [PMID: 35114311 DOI: 10.1016/j.ijpharm.2022.121529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 11/24/2022]
Abstract
The current study is a preliminary investigation on the use of stereolithography 3D printing technology in the field of personalized medicines and specifically for delivering drugs locally, which can for example usefully be applied to ear infections. The main aim is the development of drug-loaded implants for the treatment of ear diseases, to improve patient compliance and to overcome the limitations of current delivery approaches. Multiple prototypes of implant geometries have been created and printed using a flexible resin containing 0.5% w/v of Levofloxacin. Physicochemical characterization of the printed implants was carried out using a variety of techniques (e.g., microscopic, spectroscopic, and mechanical analysis). Finally, preliminary in vitro tests were performed to evaluate the release profile of Levofloxacin, the prototype implant's stability, and their antimicrobial property. The results obtained show that there is no interaction between the resin and the drug, which is perfectly solubilized in the device. In addition, the results of the mechanical tests show that the material used resists compression without compromising the design itself, and the diffusion test has shown that the drug diffused through the matrix prototype at 50% over 3 weeks. The selected designs showed higher antimicrobial activity on E. coli than on S. aureus.
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Affiliation(s)
- Alessandro Triacca
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Giulia Pitzanti
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Essyrose Mathew
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Bice Conti
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Rossella Dorati
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Dimitrios A Lamprou
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
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