ArticleThe Journal of infection2013
Bacterial and viral interactions within the nasopharynx contribute to the risk of acute otitis media.
Article in The Journal of infection, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- RSV-associated acute otitis media in children under five years old: a systematic review and meta-analysis.Journal of global health · 2026Pooled it
- The Burden of Respiratory Syncytial Virus in Children With Acute Otitis Media: A Systematic Review and Meta-Analysis.Influenza and other respiratory viruses · 2026Pooled it
- The aetiology of diarrhoea, pneumonia and respiratory colonization of HIV-exposed infants randomized to breast- or formula-feeding.Paediatrics and international child health · 2016Trial
- Perinatal exposures and upper respiratory tract microbiome composition are associated with age at first acute otitis media episode.bioRxiv : the preprint server for biology · 2026Article
- Interplay between viral infections and gut microbiota dysbiosis: Mechanisms and therapeutic potential.World journal of gastroenterology · 2026Review
- Evaluation of Streptococcus pneumoniae as a cause of acute otitis media in Colombia: A prospective study.PloS one · 2025Article
- Case-control study of relationship of infection by respiratory viruses with acute otitis media in Chinese children.Heliyon · 2023Article
- Serotype 19A and 6C Account for One-Third of Pneumococcal Carriage Among Belgian Day-Care Children Four Years After a Shift to a Lower-Valent PCV.Journal of the Pediatric Infectious Diseases Society · 2023Article
- Immunohistochemical and qPCR Detection of SARS-CoV-2 in the Human Middle Ear Versus the Nasal Cavity: Case Series.Head and neck pathology · 2022Article
- Predominant Bacterial and Viral Otopathogens Identified Within the Respiratory Tract and Middle Ear of Urban Australian Children Experiencing Otitis Media Are Diversely Distributed.Frontiers in cellular and infection microbiology · 2022Article
- Identification of the Bacterial Pathogens in Children with Otitis Media: A Study in the Northwestern Portuguese District of Braga.Microorganisms · 2021Article
- Association of nasopharyngeal viruses and pathogenic bacteria in children and their parents with and without HIV.Pneumonia (Nathan Qld.) · 2021Article
- Innate Immunity in the Middle Ear Mucosa.Frontiers in cellular and infection microbiology · 2021Review
- Nasopharyngeal colonization with pathobionts is associated with susceptibility to respiratory illnesses in young children.PloS one · 2020Article
- The Moraxella catarrhalis phase-variable DNA methyltransferase ModM3 is an epigenetic regulator that affects bacterial survival in an in vivo model of otitis media.BMC microbiology · 2019Article
- Review
- The dynamics and interactions of respiratory pathogen carriage among French pilgrims during the 2018 Hajj.Emerging microbes & infections · 2019Article
- Adaptation of pain scales for parent observation: are pain scales and symptoms useful in detecting pain of young children with the suspicion of acute otitis media?BMC pediatrics · 2018Article
- Pneumococcal Phenotype and Interaction with Nontypeable Haemophilus influenzae as Determinants of Otitis Media Progression.Infection and immunity · 2018Article
- Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesTo understand relationships between microbes in pathogenesis of acute otitis media during respiratory tract infections, we compared nasopharyngeal bacteria and respiratory viruses in symptomatic children with and without AOM.
methodsWe enrolled children (6-35 months) with acute symptoms suggestive of AOM and analyzed their nasopharyngeal samples for bacteria by culture and for 15 respiratory viruses by PCR. Non-AOM group had no abnormal otoscopic signs or only middle ear effusion, while AOM group showed middle ear effusion and acute inflammatory signs in pneumatic otoscopy along with acute symptoms.
resultsOf 505 children, the non-AOM group included 187 and the AOM group 318. One or more bacterial AOM pathogen (Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis) was detected in 78% and 96% of the non-AOM and AOM group, respectively (P < .001). Colonization with S. pneumoniae and H. influenzae, each alone, increased risk of AOM (odds ratio (OR) 2.92; 95% confidence interval (CI), .91-9.38, and 5.13; 1.36-19.50, respectively) and co-colonization with M. catarrhalis further increased risk (OR 4.36; 1.46-12.97, and 9.00; 2.05-39.49, respectively). Respiratory viruses were detected in 90% and 87% of the non-AOM and AOM group, respectively. RSV was significantly associated with risk of AOM without colonization by bacterial AOM pathogens (OR 6.50; 1.21-34.85).
conclusionsCo-colonization by M. catarrhalis seems to increase risk of AOM and RSV may contribute to AOM pathogenesis even without nasopharyngeal bacterial colonization.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.