Clin Exp Otorhinolaryngol.  2011 Sep;4(3):122-125.

Nasopharynx as a Microbiologic Reservoir in Chronic Suppurative Otitis Media: Preliminary Study

Affiliations
  • 1Department of Otolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. brune77@naver.com

Abstract


OBJECTIVES
The present study was designed to identify the correlations of bacterial strains of the middle ear and the nasopharynx in chronic suppurative otitis media (CSOM) patients who were scheduled for operations.
METHODS
Sixty-three patients with CSOM were enrolled in the study. Culture specimens were collected from the middle ear and nasopharynx of patients who were admitted for operation. Samples collections were performed 3 times; from the middle ear and nasophaynx at the admission day, from the middle ear during the operation, and from the external auditory canal post-operatively. Bacteria were identified by gram staining and biochemical tests. The correspondence rate of organisms which simultaneously exist in the middle ear and the nasopharynx was measured.
RESULTS
Sixty-eight organisms were isolated from the middle ear and 57 organisms from the nasopharynx among 63 patients. Of 68 bacteria identified in middle ear, 26.52% (18 bacteria) corresponded with those of nasopharynx. MRSA had the high correspondence rate, and of 18 methicillin-resistant Staphylococcus aureus (MRSA) isolated from middle ear, 33.3% (6 bacteria) corresponded with nasophaynx. Meanwhile, 3 organisms of MRSA were detected from the external auditory canal post-operatively, although they were only found in nasopharynx pre-operatively.
CONCLUSION
The current trend of middle ear swab alone for bacterial detection would be insufficient to identify the potent MRSA and impede early antibiotic intervention for the effective middle ear surgery. Therefore, it is necessary to perform nasopharynx cultures together with conventional middle ear culture to control potent risk for infection pre-operatively.

Keyword

Bacteriology; Chronic suppurative otitis media; Nasopharynx

MeSH Terms

Bacteria
Bacteriology
Ear Canal
Ear, Middle
Humans
Methicillin-Resistant Staphylococcus aureus
Nasopharynx
Otitis
Otitis Media, Suppurative

Reference

1. Albert RR, Job A, Kuruvilla G, Joseph R, Brahmadathan KN, John A. Outcome of bacterial culture from mastoid granulations: is it relevant in chronic ear disease? J Laryngol Otol. 2005; 10. 119(10):774–778. PMID: 16259653.
Article
2. Stroman DW, Roland PS, Dohar J, Burt W. Microbiology of normal external auditory canal. Laryngoscope. 2001; 11. 111(11 Pt 1):2054–2059. PMID: 11801996.
Article
3. Yeo SG, Park DC, Hong SM, Cha CI, Kim MG. Bacteriology of chronic suppurative otitis media: a multicenter study. Acta Otolaryngol. 2007; 10. 127(10):1062–1067. PMID: 17851935.
4. Schwartz R, Rodriguez WJ, Mann R, Khan W, Ross S. The nasopharyngeal culture in acute otitis media: a reappraisal of its usefulness. JAMA. 1979; 5. 18. 241(20):2170–2173. PMID: 34739.
Article
5. Kamme C, Lundgren K, Mardh PA. The aetiology of acute otitis media in children. Occurrence of bacteria, L forms of bacteria and mycoplasma in the middle ear exudate. Relationship between bacterial findings in the middle ear exudate, nasopharynx and throat. Scand J Infect Dis. 1971; 3(3):217–223. PMID: 4399782.
Article
6. Syrjanen RK, Herva EE, Makela PH, Puhakka HJ, Auranen KJ, Takala AK, et al. The value of nasopharyngeal culture in predicting the etiology of acute otitis media in children less than two years of age. Pediatr Infect Dis J. 2006; 11. 25(11):1032–1036. PMID: 17072126.
7. Harker LA, Shelton C. Cummings CW, Flint PW, Harker LA, Haughey BH, Robbins KT, Schuller DE, editors. Complication of temporal bone infections. Otolaryngology: head & neck surgery. 2004. 4th ed. Philadelphia: Elsevier Mosby;p. 3013–3039.
8. Koh EK. Korean Otologic Study Group. The bacteriology of cholesteatoma. Cholesteatoma. 1996. Seoul: Chung-Ang Publishing;p. 49–63.
9. Lee KS, Suh SB, Hong SJ, Shin JE. A study of ofloxacin ear drops versus amoxicillin/clavulanic acid in the treatment of chronic suppurative otitis media. Korean J Audiol. 1998; 2(2):181–189.
10. Erkan M, Aslan T, Sevuk E, Guney E. Bacteriology of chronic suppurative otitis media. Ann Otol Rhinol Laryngol. 1994; 10. 103(10):771–774. PMID: 7944167.
Article
11. Jevons MP. Celbenin: resistant Staphylococci. Br Med J. 1961; 1. 14. 1(5219):124–125.
12. Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998; 8. 20. 339(8):520–532. PMID: 9709046.
13. Kim WJ, Chang JW, Choi J, Chae SW, Jung HH, Im GJ. Result and surgical consideration for chronic suppurative otitis media with methicillin-resistant Staphylococcus aureus. Korean J Audiol. 2009; 13(3):222–225.
14. Palva T, Hallstrom O. Bacteriology of chronic otitis media: results of analyses from the ear canal and from the operative cavity. Arch Otolaryngol. 1965; 10. 82(4):359–364. PMID: 5323259.
Article
15. Harputluoglu U, Egeli E, Sahin I, Oghan F, Ozturk O. Nasopharyngeal aerobic bacterial flora and Staphylococcus aureus nasal carriage in deaf children. Int J Pediatr Otorhinolaryngol. 2005; 1. 69(1):69–74. PMID: 15627450.
Article
16. Creech CB 2nd, Kernodle DS, Alsentzer A, Wilson C, Edwards KM. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr Infect Dis J. 2005; 7. 24(7):617–621. PMID: 15999003.
Article
17. Crum NF, Lee RU, Thornton SA, Stine OC, Wallace MR, Barrozo C, et al. Fifteen-year study of the changing epidemiology of methicillin-resistant Staphylococcus aureus. Am J Med. 2006; 11. 119(11):943–951. PMID: 17071162.
Article
Full Text Links
  • CEO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr