Upper Respiratory Tract Microbial Communities, Acute Otitis Media Pathogens, and Antibiotic Use in Healthy and Sick Children

ABSTRACTThe composition of the upper respiratory tract microbial community may influence the risk for colonization by the acute otitis media (AOM) pathogensStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalis. We used culture-independent methods to describe upper respiratory tract microbial communities in healthy children and children with upper respiratory tract infection with and without concurrent AOM. Nasal swabs and data were collected in a cross-sectional study of 240 children between 6 months and 3 years of age. Swabs were cultured forS. pneumoniae, and real-time PCR was used to identifyS. pneumoniae,H. influenzae, andM. catarrhalis. The V1-V2 16S rRNA gene regions were sequenced using 454 pyrosequencing. Microbial communities were described using a taxon-based approach. Colonization byS. pneumoniae,H. influenzae, andM. catarrhaliswas associated with lower levels of diversity in upper respiratory tract flora. We identified commensal taxa that were negatively associated with colonization by each AOM bacterial pathogen and with AOM. The balance of these relationships differed according to the colonizing AOM pathogen and history of antibiotic use. Children with antibiotic use in the past 6 months and a greater abundance of taxa, includingLactococcusandPropionibacterium, were less likely to have AOM than healthy children (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.25 to 0.85). Children with no antibiotic use in the past 6 months, a low abundance ofStreptococcusandHaemophilus, and a high abundance ofCorynebacteriumandDolosigranulumwere less likely to have AOM (OR, 0.51; 95% CI, 0.31 to 0.83). An increased understanding of polymicrobial interactions will facilitate the development of effective AOM prevention strategies.

Download Full-text

Efficacy of Aminomethyl Spectinomycins against Complex Upper Respiratory Tract Bacterial Infections

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02096-18 ◽

2019 ◽

Vol 63 (5) ◽

Cited By ~ 1

Author(s):

Amy Iverson ◽

Christopher J. Meyer ◽

Peter Vogel ◽

Samanthi Waidyarachchi ◽

Nisha Das ◽

...

Keyword(s):

Single Dose ◽

Streptococcus Pneumoniae ◽

Respiratory Tract ◽

Otitis Media ◽

Respiratory Infections ◽

Acute Otitis Media ◽

Upper Respiratory Tract ◽

Content Type ◽

Upper Respiratory

ABSTRACT The most frequent ailment for which antibiotics are prescribed is otitis media (ear infections), which is most commonly caused by Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae. Treatment of otitis media is complicated by the fact that the bacteria in the middle ear typically form biofilms, which can be recalcitrant to antibiotic treatment. Furthermore, bacterial respiratory infections can be greatly exacerbated by viral coinfection, which is particularly evidenced by the synergy between influenza and S. pneumoniae. In this study, we sought to ascertain the in vivo efficacy of aminomethyl spectinomycin lead 1950, an effective antibacterial agent both in vitro and in vivo against Streptococcus pneumoniae in the context of complex respiratory infections and acute otitis media. A single dose of 1950 significantly reduced bacterial burden in the respiratory tract for all three pathogens, even when species were present in a coinfection model. Additionally, a single dose of 1950 effectively reduced pneumococcal acute otitis media from the middle ear. The agent 1950 also proved efficacious in the context of influenza-pneumococcal super infection. These data further support the development of this family of compounds as potential therapeutic agents against the common causes of complex upper respiratory tract infections and acute otitis media.

Download Full-text

Microbial Communities of the Upper Respiratory Tract and Otitis Media in Children

mBio ◽

10.1128/mbio.00245-10 ◽

2011 ◽

Vol 2 (1) ◽

Cited By ~ 118

Author(s):

Alison S. Laufer ◽

Joshua P. Metlay ◽

Janneane F. Gent ◽

Kristopher P. Fennie ◽

Yong Kong ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Respiratory Tract ◽

Microbial Communities ◽

Otitis Media ◽

Middle Ear ◽

Upper Respiratory Tract ◽

Content Type ◽

Increased Risk ◽

Causal Pathway ◽

Upper Respiratory

ABSTRACTStreptococcus pneumoniaeasymptomatically colonizes the upper respiratory tract of children and is a frequent cause of otitis media. Patterns of microbial colonization likely influenceS. pneumoniaecolonization and otitis media susceptibility. This study compared microbial communities in children with and without otitis media. Nasal swabs and clinical and demographic data were collected in a cross-sectional study of Philadelphia, PA, children (6 to 78 months) (n= 108) during the 2008-2009 winter respiratory virus season. Swabs were cultured forS. pneumoniae. DNA was extracted from the swabs; 16S rRNA gene hypervariable regions (V1 and V2) were PCR amplified and sequenced by Roche/454 Life Sciences pyrosequencing. Microbial communities were described using the Shannon diversity and evenness indices. Principal component analysis (PCA) was used to group microbial community taxa into four factors representing correlated taxa. Of 108 children, 47 (44%) were colonized byS. pneumoniae, and 25 (23%) were diagnosed with otitis media. Microbial communities withS. pneumoniaewere significantly less diverse and less even. Two PCA factors were associated with a decreased risk of pneumococcal colonization and otitis media, as follows: one factor included potentially protective flora (CorynebacteriumandDolosigranulum), and the other factor includedPropionibacterium,Lactococcus, andStaphylococcus. The remaining two PCA factors were associated with an increased risk of otitis media. One factor includedHaemophilus, and the final factor includedActinomyces,Rothia,Neisseria, andVeillonella. Generally, these taxa are not considered otitis media pathogens but may be important in the causal pathway. Increased understanding of upper respiratory tract microbial communities will contribute to the development of otitis media treatment and prevention strategies.IMPORTANCEOtitis media (middle ear infection) is the most common reason for pediatric sick visits in the United States.Streptococcus pneumoniaeis a leading otitis media pathogen.S. pneumoniaemust colonize the upper respiratory tract and compete with a complex community of nonpathogenic bacteria before infecting the middle ear. We compared microbial communities in the upper respiratory tract of children who had otitis media and those who did not. Members of the normal flora, i.e.,CorynebacteriumandDolosigranulum, were protective forS. pneumoniaecolonization and otitis media. As expected, the generaHaemophiluswas associated with otitis media. Surprisingly,Actinomyces,Rothia,Neisseria, andVeillonellawere associated with an increased risk of otitis media. These bacteria are not otitis media pathogens but may be associated with antibiotic use or involved in the causal pathway to disease. Increased understanding of upper respiratory tract microbial communities will lead to new ways to prevent middle ear infections, including probiotics.

Download Full-text