ANALYSIS OF ADULT OTITIS-MEDIA - POLYMERASE CHAIN-REACTION VERSUS CULTURE FOR BACTERIA AND VIRUSES

Recent studies using the polymerase chain reaction (PCR) have identifi ed bacterial and viral genomic sequences in culture-negative pediatric middle ear effusions. To evaluate this technique in adults, 19 effusi ons were analyzed to compare bacterial and viral culture and PCR detec tion of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella ca tarrhalis, and adenovirus. Effusions from 4 subjects positive for huma n immunodeficiency virus (HIV) were analyzed by PCR for HIV virus. Thr ee of 19 effusions were culture-positive for bacteria, and 0 of 19 for viruses. Fifteen of 19 effusions were PCR-positive for bacterial geno mic sequences, and 0 of 19 for adenovirus. Thirteen of 15 PCR-positive specimens demonstrated S pneumoniae, 5 of 15 H influenzae, and 0 of 1 3 M catarrhalis. All 4 effusions from HIV-positive subjects were PCR-p ositive for HIV. No effusion was culture-positive and PCR-negative. Th ese results confirm that culture-negative middle ear effusions contain genomic sequences from bacterial pathogens. Finding of HIV RNA and DN A in effusion from HIV-positives suggests replicating virus in this fl uid.