PMID: 10608643

Issn Print: 0891-3668

Publication Date: 1999/12/01


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Nasopharyngeal colonization with pathogens causing otitis media: how does this information help us?

MARVIN B. HARPER

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Excerpt

Information gathered from studies of nasopharyngeal (NP) colonization with microbial pathogens has been helpful in understanding risk factors for infection with these organisms, as well as for infection with organisms with reduced susceptibility to antibiotics. This article reviews data from these studies as they pertain to risk factors for otitis media and how this information is useful in guiding treatment. This article focuses on the pathogens that most commonly colonize the nasopharynx and cause otitis media: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Other pathogens, such as Streptococcus pyogenes, Staphylococcus aureus, Chlamydia trachomatis, Chlamydia pneumoniae, Mycoplasma pneumoniae and many viruses, are found in the nasopharynx and cause otitis media but occur much less often than the three primary pathogens.
NP colonization with bacterial pathogens is determined by a complex interplay of (1) exposure opportunity, i.e. the likelihood of sufficient exposure to someone carrying the organism; (2) factors effecting attachment of the organism to cells of the nasopharynx, including passive exposure to cigarette smoke, breast-feeding, age and immunity as acquired through prior exposure to that or similar organisms or prior immunization; and (3) the ability of the organism to remain a part of the resident flora, which again depends on immunity, the other resident flora and antibiotic use. In this article we discuss the epidemiology of NP colonization and its relationship to otitis media.

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