CHLAMYDIA-PNEUMONIAE IN ACUTE OTITIS-MEDIA

Background. Aerobic bacterial pathogens ae recovered from 65 to 85% of patients with acute otitis media (AOM). Although Chlamydia pneumoniae is a common pathogen of pediatric pneumonia, it has rarely been cultu red from children with chronic otitis media and its role in AOM is unk nown. Methods. We cultured for C. pneumoniae in tympanocentesis aspira tes and nasopharyngeal swabs from 101 consecutive, otherwise healthy c hildren with AOM or refractory AOM. A control group of 50 similarly ag ed, healthy children was evaluated for nasopharyngeal carriage of C. p neumoniae. Specimens were also evaluated by PCR for C. pneumoniae. Res ults. C. pneumoniae was recovered by tympanocentesis in 8 (8%) of 101 children with AOM. Among the 8 children with C. pneumoniae-positive AO M, 5 had C. pneumoniae detected by PCR in middle ear fluid, non had C. pneumoniae recovered by nasopharyngeal culture or PCR and 5 were youn ger than 16 months. C. pneumoniae was the sole pathogen isolated in 2 patients. Copathogens included beta-lactamase-positive Haemophilus inf luenzae (2), beta-lactamase positive Moraxella catarrhalis (1), penici llin-resistant Streptococcus pneumonia (2) and penicillin-susceptible S. pneumoniae (1). C. pneumoniae was recovered from nasopharyngeal cul ture in 2 additional patients with C. pneumoniae-negative AOM and in n one of 50 healthy control children, although 2 controls were positive by PCR from the nasopharynx. Conclusions. This is the first study to r eport the isolation of C. pneumoniae in middle ear fluid of children w ith AOM.