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Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media

Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media
Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media
CONTEXT: Chronic otitis media (OM) is a common pediatric infectious disease. Previous studies demonstrating that metabolically active bacteria exist in culture-negative pediatric middle-ear effusions and that experimental infection with Haemophilus influenzae in the chinchilla model of otitis media results in the formation of adherent mucosal biofilms suggest that chronic OM may result from a mucosal biofilm infection. OBJECTIVE: To test the hypothesis that chronic OM in humans is biofilm-related. DESIGN, SETTING, AND PATIENTS: Middle-ear mucosa (MEM) biopsy specimens were obtained from 26 children (mean age, 2.5 [range, 0.5-14] years) undergoing tympanostomy tube placement for treatment of otitis media with effusion (OME) and recurrent OM and were analyzed using microbiological culture, polymerase chain reaction (PCR)-based diagnostics, direct microscopic examination, fluorescence in situ hybridization, and immunostaining. Uninfected (control) MEM specimens were obtained from 3 children and 5 adults undergoing cochlear implantation. Patients were enrolled between February 2004 and April 2005 from a single US tertiary referral otolaryngology practice. MAIN OUTCOME MEASURES: Confocal laser scanning microscopic (CLSM) images were obtained from MEM biopsy specimens and were evaluated for biofilm morphology using generic stains and species-specific probes for H influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Effusions, when present, were evaluated by PCR and culture for evidence of pathogen-specific nucleic acid sequences and bacterial growth, respectively. RESULTS: Of the 26 children undergoing tympanostomy tube placement, 13 (50%) had OME, 20 (77%) had recurrent OM, and 7 (27%) had both diagnoses; 27 of 52 (52%) of the ears had effusions, 24 of 24 effusions were PCR-positive for at least 1 OM pathogen, and 6 (22%) of 27 effusions were culture-positive for any pathogen. Mucosal biofilms were visualized by CLSM on 46 (92%) of 50 MEM specimens from children with OME and recurrent OM using generic and pathogen-specific probes. Biofilms were not observed on 8 control MEM specimens obtained from the patients undergoing cochlear implantation. CONCLUSION: Direct detection of biofilms on MEM biopsy specimens from children with OME and recurrent OM supports the hypothesis that these chronic middle-ear disorders are biofilm-related.
202-211
Hall-Stoodley, Luanne
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Hu, Fen Ze
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Gieseke, Armin
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Nistico, Laura
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Nguyen, Duc
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Hayes, Jay
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Forbes, Michael
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Greenberg, David P.
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Dice, Bethany
72120cd5-bde7-4799-bba8-38cc906d14b1
Burrows, Amy
455ffacf-de30-4dc2-b373-8b4efa855c3f
Wackym, P. Ashley
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Stoodley, Paul
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Post, J. Christopher
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Ehrlich, Garth D.
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Kerschner, Joseph E.
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Hall-Stoodley, Luanne
94ebdc00-b549-4488-b15f-5310fb965f5b
Hu, Fen Ze
a6e5ffb6-a70d-4a7a-97bc-34b34d5bb0cc
Gieseke, Armin
1b9305ea-9172-4681-8667-9f638aac41f2
Nistico, Laura
7a83886a-6bf1-46a1-87dd-75a120d41603
Nguyen, Duc
f6972580-bc57-40b5-b634-4213bbd1e32a
Hayes, Jay
d019d3a7-d2fd-425f-b94c-a388fbd65abe
Forbes, Michael
15bc6163-0a33-4ec4-b7cd-46df7966e909
Greenberg, David P.
35c8cd3c-cbc6-47a3-a220-7c420cad2e55
Dice, Bethany
72120cd5-bde7-4799-bba8-38cc906d14b1
Burrows, Amy
455ffacf-de30-4dc2-b373-8b4efa855c3f
Wackym, P. Ashley
467ce61b-cb32-4db7-9da0-1518b40afbdf
Stoodley, Paul
08614665-92a9-4466-806e-20c6daeb483f
Post, J. Christopher
832cfa58-9254-4396-8c8f-6fb18cc6c18c
Ehrlich, Garth D.
aa8e5162-77a6-4627-a793-acd724ed0782
Kerschner, Joseph E.
802c8916-fcb7-4f89-8555-6643935735ec

Hall-Stoodley, Luanne, Hu, Fen Ze, Gieseke, Armin, Nistico, Laura, Nguyen, Duc, Hayes, Jay, Forbes, Michael, Greenberg, David P., Dice, Bethany, Burrows, Amy, Wackym, P. Ashley, Stoodley, Paul, Post, J. Christopher, Ehrlich, Garth D. and Kerschner, Joseph E. (2006) Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media. JAMA: the Journal of the American Medical Association, 296 (2), 202-211.

Record type: Article

Abstract

CONTEXT: Chronic otitis media (OM) is a common pediatric infectious disease. Previous studies demonstrating that metabolically active bacteria exist in culture-negative pediatric middle-ear effusions and that experimental infection with Haemophilus influenzae in the chinchilla model of otitis media results in the formation of adherent mucosal biofilms suggest that chronic OM may result from a mucosal biofilm infection. OBJECTIVE: To test the hypothesis that chronic OM in humans is biofilm-related. DESIGN, SETTING, AND PATIENTS: Middle-ear mucosa (MEM) biopsy specimens were obtained from 26 children (mean age, 2.5 [range, 0.5-14] years) undergoing tympanostomy tube placement for treatment of otitis media with effusion (OME) and recurrent OM and were analyzed using microbiological culture, polymerase chain reaction (PCR)-based diagnostics, direct microscopic examination, fluorescence in situ hybridization, and immunostaining. Uninfected (control) MEM specimens were obtained from 3 children and 5 adults undergoing cochlear implantation. Patients were enrolled between February 2004 and April 2005 from a single US tertiary referral otolaryngology practice. MAIN OUTCOME MEASURES: Confocal laser scanning microscopic (CLSM) images were obtained from MEM biopsy specimens and were evaluated for biofilm morphology using generic stains and species-specific probes for H influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Effusions, when present, were evaluated by PCR and culture for evidence of pathogen-specific nucleic acid sequences and bacterial growth, respectively. RESULTS: Of the 26 children undergoing tympanostomy tube placement, 13 (50%) had OME, 20 (77%) had recurrent OM, and 7 (27%) had both diagnoses; 27 of 52 (52%) of the ears had effusions, 24 of 24 effusions were PCR-positive for at least 1 OM pathogen, and 6 (22%) of 27 effusions were culture-positive for any pathogen. Mucosal biofilms were visualized by CLSM on 46 (92%) of 50 MEM specimens from children with OME and recurrent OM using generic and pathogen-specific probes. Biofilms were not observed on 8 control MEM specimens obtained from the patients undergoing cochlear implantation. CONCLUSION: Direct detection of biofilms on MEM biopsy specimens from children with OME and recurrent OM supports the hypothesis that these chronic middle-ear disorders are biofilm-related.

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Published date: 12 July 2006
Organisations: Engineering Mats & Surface Engineerg Gp

Identifiers

Local EPrints ID: 155945
URI: http://eprints.soton.ac.uk/id/eprint/155945
PURE UUID: 59dcfb1b-0389-4028-808b-0c2d9f99563a
ORCID for Paul Stoodley: ORCID iD orcid.org/0000-0001-6069-273X

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Date deposited: 08 Jun 2010 10:30
Last modified: 23 Jul 2022 02:00

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Contributors

Author: Luanne Hall-Stoodley
Author: Fen Ze Hu
Author: Armin Gieseke
Author: Laura Nistico
Author: Duc Nguyen
Author: Jay Hayes
Author: Michael Forbes
Author: David P. Greenberg
Author: Bethany Dice
Author: Amy Burrows
Author: P. Ashley Wackym
Author: Paul Stoodley ORCID iD
Author: J. Christopher Post
Author: Garth D. Ehrlich
Author: Joseph E. Kerschner

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