Detection of Haemophilus Influenzae and Streptococcus Pneumoniae by Polymerase Chain Reaction (PCR) in Chronic Otitis Media with Effusion (OME) / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Otitis media with effusion (OME) is one of the major causes of hearing loss in childhood. The pathogenesis still remains unclear, although it is closely related to bacterial infections. Thus, it is necessary to develop a sensitive and specific method to detect of bacteria in OME in order to examine the relationship between bacterial infection and the pathogenesis of OME. To determine if the polymerase chain reaction (PCR) can detect bacterial DNA in pediatric middle ear effusions that are sterile by standard cultural methods. MATERIALS AND METHODS: total of 52 middle ear effusions were collected from pediatric patients during myringotomy and the ventilation tube insertion. All patients had failed multiple courses of antimicrobial therapy. PCR and the conventional culture method were applied to detect Haemophilus influenzae and Streptococcus pneumoniae in the middle ear effusions. RESULTS: Of the 52 specimens of OME, 3 (6%) tested positive by culture for Staphylococcus aureus, 1 (2%) for Gram positive bacilli. H. influenzae and S. pneumoniae were not detected by culture in all samples. But 32 (61.5%) were positive for H. influenzae and 7 (13%) for S. pneumoniae by PCR. The positive rate was significantly greater with PCR than with the culture method. CONCLUSION: The PCR assay is useful to detect middle ear pathogens of OME, even in the "sterile" fluids by the conventional bacterial culture. PCR positive specimens from the middle ear pediatric patients are suggestive of bacterial infections.