A bacteriological study of the middle ear and upper respiratory tract in children with chronic secretory otitis media

Abstract

Middle ear effusions and swabs from the external auditory meatus, nasopharynx and anterior nares have been collected from 100 children with chronic secretory otitis media. Isolates of Haemophilus influenzae and Streptococcus pneumoniae were typed and in vitro sensitivities to commonly used antibiotics were determined for these species and Staphylococcus aureus. Positive middle ear cultures were obtained from 21 children (27 effusions). Haemophilus influenzae and S. pneumoniae were the commonest organisms isolated, both from the middle ear and upper respiratory tract. When one or other of these species was isolated from the middle ear, the same organism was generally found in the upper respiratory tract, but not in the ear canal. The serotypes isolated from the different sites were also the same. Type 19 was the commonest Pneumococcal serotype isolated, while type e was the commonest capsulated strain of H. influenzae. Thirty-six per cent of strains of H. influenzae were resistant to penicillin and 25% of those of S. pneumoniae were resistant to trimethaprim. Eighty-one per cent of isolates of S. aureus were penicillin resistant. There was no difference in the incidence of either S. pneumoniae or H. influenzae in the post nasal spaces of children who had had their adenoids removed and those who had not.