Bacteriological and immunological study of childhood otitis media especially H.influenzae infection and role of cytokines

ABSTRACT

Middle ear fluids [MEFs] from 500 children of whom 150 children aged 3 months to 2 years presented with acute suppurative otitis media [ASOM] and 350 children aged 2-8 year diagnosed as chronic suppurative otitis media [CSOM] with perforated drum membrane were examined bacteriologically for the causative bacteria. Gram- positive cocci; including S. pneumoniae, S. viridans were the most common causes of ASOM. Whereas in CSOM, both Gram- negative bacilli, including P. aeruginosa, P. mirabilis, E. coli, H. influenzae and Gram- positive cocci were equally affecting he middle ear [42% and 42.6% respectively] H. influnzae was isolated from cases of ASOM and CSOM with a percentagte of 10 and 2.6 respectively. Biotype [IV] was the commonest biotype isolated from ASOM and CSOM with a percentage of 60 and 77.8 respectively. Serotype [b] seems to be more frequently associateed with biotype [IV] which was the commonest biotype in non capsulated strains. Using the Enzyme Linked Immunosorbent Assay [ELISA] system, the number of positive cases for interlukin-1 [IL-[1]], in cases of ASOM was of high statistical significant value [P<0.001] compared with that of CSOM and the number of positive cases for tumour necrosis factor [TNF] in cases of CS OM was of high statistical significant value [P<0.001] Compared with that of ASOM. The level of [IL-[1]] in cases of ASOM was of high statistical significant value [P<0.001] compared with that in cases of CSOM but the level of IL-[6] in cases of ASOM was of statistical significant value compared with that in cases of CSOM [P<0.05]. TNF levels in cases of CSOM was of high statistical significant value compared with that in cases of ASOM [P<0.001]. This may explain, on immunological basis, the frequent recurrences of ASOM and the more destructive pathologly in CSOM