The role of biofilms in otitis media has received an increasing amount of attention recently, particularly in the setting of recurrent otitis media and otitis media with effusion. Although the presence of bacterial DNA may indicate the presence of viable but nonculturable bacteria, the significance of these observations is not yet fully known. catarrhalis DNA is detected in a larger proportion of cases of otitis media with effusion than of acute otitis media. pneumoniae, suggesting that bacteria play a role in the disease. When middle ear fluid samples from children who have otitis media with effusion are analyzed using sensitive methods such as polymerase chain reaction, up to 80% contain bacterial DNA from H. Otitis prone children may experience conductive hearing loss, with resultant delays in speech and language development.
Children who have ⩾4 episodes of acute otitis media in a year or who experience at least 8 months of middle ear effusion in a year are defined as otitis prone. Otitis media with effusion refers to the presence of middle ear fluid without clinical signs of acute otitis media. Recurrent otitis media and otitis media with effusion. Therefore, treatment of otitis media is generally empirical. Tympanocentesis is required to make an etiological diagnosis of otitis media, but this procedure is not performed routinely. However, substantial overlap is observed, such that these characteristics do not allow one to predict etiology in an individual patient. pneumoniae, with less fever and a lower likelihood of observing a red bulging tympanic membrane. influenzae are clinically milder than that caused by S. The black portions of the bars represent samples that grew Moraxella catarrhalis in culture, the white portions represent samples that grew nontypeable Haemophilus influenzae in culture, and the gray portions represent samples that grew Streptococcus pneumoniae in culture.Īcute otitis media due to M. Some cultures grew ⩾1 species, which accounts for totals >100%. Bars represent the percentage of middle ear fluid samples that were positive by culture. īacterial causes of otitis media, according to results of culture of middle ear fluid obtained by tympanocentesis from 8 studies published from 1992 through 2006. Overall, on the basis of cultures of middle ear fluid, 15%-20% of acute otitis media episodes are caused by M.
catarrhalis are the predominant causes of acute otitis media. On the basis of culture of middle ear fluid obtained by tympanocentesis, which is the gold standard for determining etiology, Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and M. Otitis media is the most common bacterial infectious disease in childhood and the most common reason for which children receive antibiotics. Approximately 80% of children experience an episode of otitis media by the age of 3 years. catarrhalis and Otitis MediaĪcute otitis media.
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In addition, we will highlight recent work elucidating mechanisms of pathogenesis and update the status of vaccine development. catarrhalis, particularly as a causal agent of otitis media in children and exacerbations of chronic obstructive pulmonary disease (COPD) in adults, the 2 most common infectious diseases caused by M. The objective of this review is to outline the clinical manifestations and epidemiology of M. More recently, the widespread use of pneumococcal conjugate vaccines has altered nasopharyngeal colonization patterns and caused an increased prevalence of colonization and infection by M. catarrhalis as a common respiratory tract pathogen in children and adults has stimulated novel investigation over the past 2 decades into the microbiology, molecular epidemiology, pathogenesis, genetics, and host response to M. One lineage that expanded in humans ∼5 million years ago is associated with virulence properties, including serum resistance and adherence to epithelial cells. catarrhalis is composed of 2 distinct lineages. Branhamella catarrhalis was subsequently placed in the genus Moraxella on the basis of biochemical and genetic relatedness, and Moraxella catarrhalis is now the widely accepted name. The bacterium was transferred to a new genus, Branhamella, in 1970, because of limited DNA homology with Neisseria species. After having initially been named Micrococcus catarrhalis, the organism's name was subsequently changed to Neisseria catarrhalis, because of its similarities in phenotype and ecological niche to commensal Neisseria species. catarrhalis has an interesting and checkered taxonomic history.
catarrhalis is an important and common human respiratory tract pathogen. However, since the late 1970s it has been clear that M. For most of the past century, Moraxella catarrhalis was regarded as an upper respiratory tract commensal organism.
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