In spite of the availability of effective antimicrobial therapy, Otitis media with effusion (OME) is still an important infection leading to serious health problems in both children and adults. (Streptococcus pneumonia) S. pneumoniae is one of the most frequently isolated bacteria from middle ear effusion (MEE) samples of OME patients. Since it is fastidious bacteria, various problems may arise in the rapid diagnosis of OME settings. Knowing which bacterium is involved is essential for the prognosis and treatment of otitis media with effusion, as the high frequency of its presentation may be linked to the aetiology and/or course of the process in many patients. Objective: The aim of this study was to evaluate the use of nested polymerase chain reaction (PCR) assay for S.pneumoniae as a diagnostic tool in patient with OME, and to detect the relation of the organism to other factors contributed to pathogenesis of OME. Subjects and Methods Middle ear fluid samples were aspirated..from 34 patients presented with OME. f-aeh sample was subjected to cultivation OIJ selective media, and nested PCR test using specific primers directed to selected pneumol)'sin gene_ jragment of S.pneumoniae. Results: S.pneumoniae was recovered by culture in 4/34 (11.87 %) of middlear fluid samples; 3/4 (75%) ji-om children and 114 (25%) .(rop1 Adults. Nested PCR detected S.pneumoniae in 11/34 (32.4%) of the samples; 8111 (72.7%) were chilcb:en and 3/11 (27.3%) were adults. All culture positive samples were PCR p6sitive, but 7 (63.6%) of the PCR positive samples were culture negative. There were strong effects of the age, pe111ious histo1y of acute otitis media, sinusitis dnd allergic rhinitis. The recove1y rate of the organism was (72.7%, 54.5 %, 36.4% .and 27.3%) respectively. Conclusion S.pneumoniae was detected in high rates in MEE samples .This suggests that it may play a role in the pathogenesis of otitis media with e.ffi1sion. In addition, PCR was more sensitive com pared to culture for detection ofS. pneumoniae in MEE samples.
|
