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Bacterial pathogens of otitis media and sinusitis: Detection in the nasopharynx with selective agar media

  • Sharon Dudley
    Affiliations
    Department of Clinical Microbiology; Department of Pediatrics; and Department of Otolaryngology, Head and Neck Surgery, University of Virginia Health System. Charlottesville, Virginia
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  • Kathleen Ashe
    Affiliations
    Department of Clinical Microbiology; Department of Pediatrics; and Department of Otolaryngology, Head and Neck Surgery, University of Virginia Health System. Charlottesville, Virginia
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  • Birgit Winther
    Affiliations
    Department of Clinical Microbiology; Department of Pediatrics; and Department of Otolaryngology, Head and Neck Surgery, University of Virginia Health System. Charlottesville, Virginia
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  • J.Owen Hendley
    Affiliations
    Department of Clinical Microbiology; Department of Pediatrics; and Department of Otolaryngology, Head and Neck Surgery, University of Virginia Health System. Charlottesville, Virginia
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      Abstract

      Carriage rates for the bacterial pathogens associated with otitis media (Streptococcus pneumoniae [SP], Hemophilus influenzae [HI], and Moraxella catarrhalis [MC]) are of interest. Culture on three selective agars was compared with culture on two standard agars to determine the more accurate method for detection of these species in the nasopharynx of healthy children. Weekly samples were obtained in winter from 18 healthy children (ages 1 through 9 years) as part of a longitudinal study. A 0.1-mL sample of 116 nasopharyngeal aspirate/washes was inoculated onto each of five agars. Two were standard (sheep blood and chocolate), and three were selective (blood with gentamicin for SP; chocolate with vancomycin, bacitracin, and clindamycin for HI; blood with amphotericin B, vancomycin, trimethoprim, and acetazolamide for MC). One technician read the standard plates and another the selective; both were blinded to the results of the other. SP was found in 44% of samples with selective agar versus 25% with standard agar; HI was found in 31% with selective versus 9% with standard; MC was found in 56% with selective versus 37% with standard. Overall, 80% of samples had one or more pathogens detected with selective agars as compared with 58% with standard agars (P =.0004). Selective agars were more accurate than standard agars for detecting otitis pathogens in the nasopharynx, where they are a common part of normal flora in healthy children. (J Lab Clin Med 2001;138:338-42)

      Abbreviations:

      CFU (colony-forming unit), HI (Hemophilus influenzae), MC (Moraxella catarrhalis), SP (Streptococcus pneumoniae)
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