RELATIONSHIP BETWEEN NASOPHARYNGEAL COLONIZATION AND THE DEVELOPMENT OF OTITIS-MEDIA IN CHILDREN

Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Mora xella catarrhalis are the predominant bacteria associated with otitis media. A cohort of 306 infants was followed from birth through 12 mont hs to determine frequency and duration of colonization and risk of acu te otitis media (AOM) and otitis media with effusion (OME). M. catarrh alis was the most common bacterium isolated. Infants colonized at less than or equal to 3 months of age were at increased risk of AOM and OM E. Early colonization with M. catarrhalis revealed the greatest risk ( relative risk [RR] = 1.24), especially for OME (RR = 1.57). There was a strong relationship between the frequency of colonization and OM (r = .37, P < .001,) for each pathogen. Although S. pneumoniae, nontypeab le H. influenzae, and M. catarrhalis are part of the normal nasopharyn geal flora during infancy, an increased rate of colonization may ident ify a subpopulation of children that is at increased risk of OM.