ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2017
Recurrent otorrhea in chronic suppurative otitis media: is biofilm the missing link?
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Pooled it
- Management Strategies for Chronic Suppurative Otitis Media and Why They Fail.Journal of the Association for Research in Otolaryngology : JARO · 2025Review
- Characteristic of Virulence and Parameters of Mixed Biofilm Formed by Carbapenem-ResistantPathogens (Basel, Switzerland) · 2025Article
- Microbiological Spectrum and Antibiotics Sensitivity Pattern of Chronic Suppurative Otitis Media (CSOM) Patients: A prospective study from a Tertiary Care Hospital in Peshawar.Pakistan journal of medical sciences · 2025Article
- Clinical impact of major pathogenic genotypes of Pseudomonas aeruginosa associated with refractory chronic suppurative otitis media.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Otitis media: recent advances in otitis media vaccine development and model systems.Frontiers in microbiology · 2024Review
- Microbiological Assessment of Chronic Otitis Media: Aerobic Culture Isolates and Their Antimicrobial Susceptibility Patterns.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2022Article
- Non-typeableEuropean respiratory review : an official journal of the European Respiratory Society · 2022Review
- Profile of aerobic bacteria and their antibiotic sensitivity in chronic suppurative otitis media in Al-Ramadi Teaching Hospital, Ramadi City, Iraq.Qatar medical journal · 2021Article
- Subversion of host immune responses by otopathogens during otitis media.Journal of leukocyte biology · 2019Review
- Direct Analysis of Pathogenic Structures Affixed to the Tympanic Membrane during Chronic Otitis Media.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2018Article
- Aerobic bacteria associated with chronic suppurative otitis media in Angola.Infectious diseases of poverty · 2018Article
- Clinical translation of handheld optical coherence tomography: practical considerations and recent advancements.Journal of biomedical optics · 2017Article
- Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh.Pakistan journal of medical sciencesArticle
- Assessing the Role of Nasal Irrigation in Chronic Otorrhea in Children With Tympanostomy Tubes.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-facialeArticle
- High Prevalence of Antibiotic-Resistant Otitis Media-Associated Bacterial Flora of Asymptomatic People Living with HIV at Morogoro Hospital, Tanzania.Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Dispersal of bacteria from a biofilm in the middle ear, serving as a bacterial reservoir, could explain the recurrent and chronic nature of chronic suppurative otitis media (CSOM). The objective of this study is to investigate if the same strains of bacteria could be detected in repeated episodes of otorrhea in CSOM. In a prospective case series at a primary healthcare clinic in Nuuk, Greenland, patients with more than 14 days of otorrhea were included consecutively. Samples for culturing and biofilm analysis were taken at enrollment and at any subsequent episode with otorrhea. Participants were treated with daily saline irrigation and Ciprofloxacin eardrops for 7-14 days. Biofilm was identified in otorrhea in 81% (17/21) of participants at enrollment. Multispecies infections dominated with Non-typeable Haemophilus Influenzae (NTHI), Staphyloccocus aureus, and anaerobes being the most frequent pathogens. After the initial treatment, 19 (90%) had dry ears. Median observation period was 140 days (range 14-280) where 13 participants had one or more recurrences. Median time to first recurrence was 60 days (range 14-197). Among the 13 with recurrence, three individuals had the same genotype of bacteria at a subsequent episode. Another two had the same phenotype (NTHI). The remaining eight had new multispecies infections. We confirmed a high rate of biofilm in CSOM. However, the clinical implication might be of minor importance when treating with irrigation and antibiotic eardrops, as recurrent episodes of otorrhea were dominated by new pathogens in each episode.
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Registered trials
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