To that end, this team of academic and clinical investigators used a device called the PlexID that can detect a broad range of bacteria in a clinical sample, and then used PCR and fluorescence in situ hybridization (FISH) probes to corroborate the presence of middle ear pathogens in the biofilms. That work fingered H. influenzae as the major culprit. "Clinically, our data explain why adenoidectomy helps with otitis media effusion since it removes a reservoir of pathogenic bacteria in the upper respiratory tract that can lead to otitis media," says Hall-Stoodley. That doesn't necessarily mean that clinicians will automatically recommend adenoidectomy as the primary surgical treatment, she adds. Nonetheless, "We are convinced that H. influenzae is a uniquely important pathogen in chronic otitis media," she says.
"I think that scientists have begun to think about chronic otitis media in a new way, and investigation of the pathogenesis of this complex disease will help in the design of novel therapies that do not depend on antibiotic treatment alone," says Hall-Stoodley. "Chronic middle ear infection can cause hearing impairment, which can affect verbal ability and education in children."
Hall-Stoodley notes that the use of bacterial culture to try to understand complex diseases such as otitis media has failed to provide a "complete understanding of the microbial complexitythe microbiomethat may be present in the nasopharynx," and that culture alone can no longer be the gold standard for identification of pathogens.
(L. Nistico, R. Kreft, A. Gieseke, J.M. Coticchia, A. Borrows, P. Khampang, Y. Liu, J.E. Kerschner, J.C. Post, S. Lonergan, R. Sampath, F.Z. Hu, G.D. Ehrlich, P. Stoodley, and L. Hall-Stoodley, 2011. Adenoid reservoir for pathogenic biofilm bacteria. J. Clin. Microbiol. 49:1411-1420.)
|Contact: Jim Sliwa|
American Society for Microbiology