FAILURE TO DETECT CHLAMYDIA PNEUMONIAE IN EAR FLUIDS FROM CHILDREN WITH OTITIS MEDIA

Chlamydia pneumoniae is a common cause of acute respiratory infections including pneumonia, bronchitis and sinusitis. Other respiratory diseases that have been associated with C. pneumoniae are asthma and otitis media. Because acute, chronic and relapsing otitis media is common in children, we evaluated C. pneumoniae as a cause of middle ear infection in this age group. Patients were 75 children of both sexes and between 6 months and 12 years of age who were referred to the Pacific Northeast community hospital for myringotomy or tympanostomy tube placement for otitis media with effusion. Sixty-six patients (88%) were 5 years old or younger. Forty-one patients (55%) had had previous episodes of ear infection and all patients were considered to have chronic infections. Forty-four patients (59%) had received multiple antibiotic regimens of amoxicillin, a cephalosporin, trimethoprim-sulfamethoxazole and/or erythromycin. Patients who had an underlying immunodeficiency or were given antibiotics 2 days before sampling were excluded. Middle ear fluid was collected at the time of tympanostomy. Ear fluids were placed in 1 ml of chlamydial transport medium SPG (sucrose-phosphate-glutamic acid) and frozen at -70 degree C for isolation. The remaining portion of fluids were frozen at -20 degree C for testing for C. pneumoniae-specific antibodies. C. pneumoniae was not isolated from any of the 117 specimens collected from 75 patients. Eight patients had been treated with erythromycin. PCR results were also negative in all 30 selected specimens tested. No C. pneumoniae-specific antibodies were detected in 63 specimens from 38 patients, 3 of whom were 5 years old or older. Bacterial cultures were positive for Haemophilus influenzae in 13 of 75 (17%) patients and Moraxella catarrhalis in 10 of 75 (13%) patients. Other organisms isolated ( less than or equal to 6%) were Streptococcus pneumoniae, Staphylococcus spp., Enterococcus spp., diphtheroids, Pseudomonas aeruginosa and Serratia marcescens. Our study of 75 chronic otitis media cases showed that C. pneumoniae is rare in young children with this disease.