The etiology of otitis media with effusion (OME) is unclear but infective agents may contribute to its pathogenesis. The knowledge of the bacterial epidemiology of OME in different geographical areas is crucial for the implementation of rational treatment, when indicated. AIM: To determine the prevalence of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Alloiococcus otitidis in the middle ear effusion of children with recurrent otitis media (ROM) and chronic OME undergoing miryngotomy and to compare the results obtained by culture and PCR. STUDY DESIGN: Clinical study with transversal cohort. MATERIAL AND METHOD: A total of 128 effusions recovered by tympanocentesis from 75 children aged 11 months to 10 years were analyzed by culture and multiplex PCR. RESULTS: Bacteria were cultured in 25.1% and the major pathogens were found in 19.6%. A.otitidis was not detected by culture. PCR yielded positive for bacteria in 85.9% of the samples and the individual results were: A.otitidis, 52.3%; H.influenzae, 39.1%; S.pneumoniae, 12.5%, and M.catarrhalis, 10.2%. PCR was significantly more sensitive than culture (P<0.01). S.pneumoniae was more frequently found in ROM when compared to chronic OME (P=0.038). CONCLUSIONS: The prevalence of bacteria in OME in a group of Brazilian children is similar to those reported from other countries, and H.influenzae was the most frequently found microorganism among the main middle ear pathogens. S.pneumoniae was more prevalent in ROM when compared to chronic OME. PCR is more sensitive in detecting bacteria in the middle ear effusion, compared to conventional culture methods, and is essential for the detection of A.otitidis. The high recovery rate of A.otitidis warrants further investigation of its role in initiating or prolonging middle ear disease.
otitis media; otitis media with effusion; ear, middle; alloiococcus otitidis; PCR; child
