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Microbiology of middle ear effusions from 292 patients undergoing tympanostomy tube placement for middle ear disease.

Poetker DM, Lindstrom DR, Edmiston CE, Krepel CJ, Link TR, Kerschner JE

Division of Pediatric Otolaryngology, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.

OBJECTIVE: Otitis media is one of the most commonly diagnosed childhood illnesses. Ideally, culture directed therapy for otitis media would be available, however, the common approach is to treat infections with antibiotics that cover the most common pathogens. The objective of this study is to describe the pathogens cultured from the middle ear effusions (MEE) of patients that underwent tympanostomy tube placement for middle ear disease, compare these results with previous studies, and assess for trends suggestive of changes in the microbiology of these patients. METHODS: Patients were invited to participate after the decision to place ventilation tubes had been made. A standard anterior-inferior myringotomy was made for placement of the ventilation tube. After myringotomy, patients had their ears suctioned and all effusions were collected for microbiologic analysis. RESULTS: A total of 292 patients were enrolled in the study, a total of 270 MEE samples were taken. Haemophilus influenzae and Moraxella catarrhalis were seen in 24 of 148 (16.2%) and 15 of 148 (10.1%), respectively. Neisseria meningitidis, Staphylococcus aureus and Corynebacterium species were each identified in 11 of the 148 pathogens isolated (7.4%). Streptococcus pneumoniae was identified in 6 of the 148 isolated pathogens (4.1%). CONCLUSION: Despite a high number of non-pathogenic bacteria, and a high number of culture negative effusions, we demonstrated pathogen rates consistent with other reports in the literature. Future directions include using more specific techniques such as PCR to better understand the microbiology of middle ear effusions.

Published 11 May 2005 in Int J Pediatr Otorhinolaryngol, 69(6): 799-804.
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