Otitis media and biofilm: An overview

Otitis media (OM) is a group of complex infective and inflammatory conditions affecting the middle ear, with a variety of subtypes differing in presentation and associated complications. It is the highest cause of pediatric health-care visits and antibiotic prescriptions internationally. It has been stated that approximately 75% of children under age three suffer from middle-ear infections. OM complications are the essential cause of preventable hearing loss, particularly in low-resource settings. Currently, scientists have confirmed that bacteria form colonies in the middle ear and are responsible for chronic infections. While bacteria are often thought of as independently free-floating living microorganisms, most of the bacteria and fungus forms organize complex communities and attach to surfaces called biofilm. Biofilm formation is considered as a survival strategy by bacteria to counteract traditional approaches (such as antibiotics) which are effective against bacteria. Biofilms are almost impossible to grow in the laboratory media and are incredibly resistant to antimicrobials which mean that the diagnosis of chronic OM is one of the most challenging in the management of middle-ear infection. This article aims to provide an appraisal of current scientific successes within the field of OM research and clinical management.