Bacteria are isolated in 59 to 90% of cases of acute otitis media (OSA) with and without otorrhea, in 20 to 49% of cases, viruses are detected. However, in at least 15% of patients, the etiology of the disease remains unknown.

Turkish scientists have conducted a study to clarify the etiology of acute middle ear infection. Modern microbiological techniques have been used to detect both bacteria and viruses. The study involved 79 young children who had recently had a tympanostomy and who fell ill with ACC, which was accompanied by a new episode (less than 48 hours from the time of the first episode) of otorrhea through a tympanostomy tube. Middle ear fluid samples were taken through a tympanostomy tube. For the detection of bacteria, culture studies and polymerase chain reaction (PCR) were used; the detection of the virus was carried out by cultural studies, the determination of antigens and PCR.

In 76 children (96%), at least one pathogen was identified. Bacteria were isolated in 73 cases (92%) and viruses in 55 cases (70%). In 52 patients (66%), bacteria and viruses were detected. Typical BAC pathogens (S. pneumoniae, H. influenzae and / or M. catarrhalis) were isolated in 86% of patients. S. pneumoniae stood out in 39 cases (49%), H. influenzae in 23 (29%) and M.catarrhalis in 22 (28%). Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pyogenes were etiologically significant pathogens in 3 children, 2 children and 1 child, respectively. One patient exuded Corynebacterium pseudodiphteriticum. In 14 children (18%), microbial associations were isolated. Picornaviruses represented 60% of all viruses detected.

According to the results of the study, in the vast majority of children, ACC is caused simultaneously by bacteria and viruses. A functional tympanostomy tube does not alter the spectrum of CCA pathogens. The etiology of the disease can be established in almost all cases.

Respiratory viruses not only trigger the pathogenic cascade of ACC, but also interact with bacteria in the middle ear cavity during infection. It is therefore even more important to prevent viral respiratory infections, for example by influenza vaccination.