Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen
Otitis media is endemic in remote Indigenous communities of Australia's Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM) in this population. The aims of this study were to dete...
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| creator | Marsh, Robyn L Binks, Michael J Beissbarth, Jemima Christensen, Peter Morris, Peter S Leach, Amanda J Smith-Vaughan, Heidi C |
| description | Otitis media is endemic in remote Indigenous communities of Australia's Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM) in this population. The aims of this study were to determine the presence, antibiotic susceptibility and bacterial load of A. otitidis in nasopharyngeal and ear discharge swabs collected from Indigenous Australian children with AOM with perforation.
Paired nasopharyngeal and ear discharge swabs from 27 children with AOM with perforation were tested by A. otitidis quantitative PCR (qPCR). Positive swabs were cultured for 21 days. Total and respiratory pathogen bacterial loads in A. otitidis-positive swabs were determined by qPCR.
A. otitidis was detected by qPCR in 11 ear discharge swabs from 10 of 27 (37%) children, but was not detected in paired nasopharyngeal swabs. A. otitidis was cultured from 5 of 11 qPCR-positive swabs from four children. All A. otitidis isolates had minimum inhibitory concentrations consistent with macrolide resistance. All A. otitidis qPCR-positive swabs were culture-positive for other bacteria. A. otitidis bacterial load ranged from 2.2 × 104-1.1 × 108 cells/swab (median 1.8 × 105 cells/swab). The relative abundance of A. otitidis ranged from 0.01% to 34% of the total bacterial load (median 0.7%). In 6 of 11 qPCR-positive swabs the A. otitidis relative abundance was |
| doi_str_mv | 10.1186/1472-6815-12-11 |
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Paired nasopharyngeal and ear discharge swabs from 27 children with AOM with perforation were tested by A. otitidis quantitative PCR (qPCR). Positive swabs were cultured for 21 days. Total and respiratory pathogen bacterial loads in A. otitidis-positive swabs were determined by qPCR.
A. otitidis was detected by qPCR in 11 ear discharge swabs from 10 of 27 (37%) children, but was not detected in paired nasopharyngeal swabs. A. otitidis was cultured from 5 of 11 qPCR-positive swabs from four children. All A. otitidis isolates had minimum inhibitory concentrations consistent with macrolide resistance. All A. otitidis qPCR-positive swabs were culture-positive for other bacteria. A. otitidis bacterial load ranged from 2.2 × 104-1.1 × 108 cells/swab (median 1.8 × 105 cells/swab). The relative abundance of A. otitidis ranged from 0.01% to 34% of the total bacterial load (median 0.7%). In 6 of 11 qPCR-positive swabs the A. otitidis relative abundance was <1% and in 5 of 11 it was between 2% and 34%. The A. otitidis bacterial load and relative abundance measures were comparable to that of Haemophilus influenzae.
A. otitidis can be a dominant species in the bacterial communities present in the ear discharge of Indigenous children with AOM with perforation. The absence of A. otitidis in nasopharyngeal swabs suggests the ear canal as the likely primary reservoir. The significance of A. otitidis at low relative abundance is unclear; however, at higher relative abundance it may be contributing to the associated inflammation. Further studies to better understand A. otitidis as a secondary otopathogen are warranted, particularly in populations at high-risk of progression to chronic suppurative otitis media and where macrolide therapies are being used.</description><identifier>ISSN: 1472-6815</identifier><identifier>EISSN: 1472-6815</identifier><identifier>DOI: 10.1186/1472-6815-12-11</identifier><identifier>PMID: 23033913</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Abundance ; Alloiococcus otitidis ; Analysis ; Antibiotics ; Australian aborigines ; Children ; Children & youth ; Commensals ; Drug resistance in microorganisms ; Ear ; Ear canal ; Eardrum ; Ears & hearing ; Haemophilus influenzae ; Inflammation ; Medical research ; Middle ear ; Minimum inhibitory concentration ; Nose ; Otitis media ; Pathogens ; Pharynx ; Polymerase chain reaction ; Risk groups ; Studies ; Territory</subject><ispartof>BMC ear, nose and throat disorders, 2012-10, Vol.12 (1), p.11-11, Article 11</ispartof><rights>COPYRIGHT 2012 BioMed Central Ltd.</rights><rights>2012 Marsh et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright ©2012 Marsh et al.; licensee BioMed Central Ltd. 2012 Marsh et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b609t-6c1d704a52b4b496ec709e8289430b29e175f0e3315d11ae3c21597ef2722ed3</citedby><cites>FETCH-LOGICAL-b609t-6c1d704a52b4b496ec709e8289430b29e175f0e3315d11ae3c21597ef2722ed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546424/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546424/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,24803,27926,27927,53793,53795,75740,75741</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23033913$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marsh, Robyn L</creatorcontrib><creatorcontrib>Binks, Michael J</creatorcontrib><creatorcontrib>Beissbarth, Jemima</creatorcontrib><creatorcontrib>Christensen, Peter</creatorcontrib><creatorcontrib>Morris, Peter S</creatorcontrib><creatorcontrib>Leach, Amanda J</creatorcontrib><creatorcontrib>Smith-Vaughan, Heidi C</creatorcontrib><title>Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen</title><title>BMC ear, nose and throat disorders</title><addtitle>BMC Ear Nose Throat Disord</addtitle><description>Otitis media is endemic in remote Indigenous communities of Australia's Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM) in this population. The aims of this study were to determine the presence, antibiotic susceptibility and bacterial load of A. otitidis in nasopharyngeal and ear discharge swabs collected from Indigenous Australian children with AOM with perforation.
Paired nasopharyngeal and ear discharge swabs from 27 children with AOM with perforation were tested by A. otitidis quantitative PCR (qPCR). Positive swabs were cultured for 21 days. Total and respiratory pathogen bacterial loads in A. otitidis-positive swabs were determined by qPCR.
A. otitidis was detected by qPCR in 11 ear discharge swabs from 10 of 27 (37%) children, but was not detected in paired nasopharyngeal swabs. A. otitidis was cultured from 5 of 11 qPCR-positive swabs from four children. All A. otitidis isolates had minimum inhibitory concentrations consistent with macrolide resistance. All A. otitidis qPCR-positive swabs were culture-positive for other bacteria. A. otitidis bacterial load ranged from 2.2 × 104-1.1 × 108 cells/swab (median 1.8 × 105 cells/swab). The relative abundance of A. otitidis ranged from 0.01% to 34% of the total bacterial load (median 0.7%). In 6 of 11 qPCR-positive swabs the A. otitidis relative abundance was <1% and in 5 of 11 it was between 2% and 34%. The A. otitidis bacterial load and relative abundance measures were comparable to that of Haemophilus influenzae.
A. otitidis can be a dominant species in the bacterial communities present in the ear discharge of Indigenous children with AOM with perforation. The absence of A. otitidis in nasopharyngeal swabs suggests the ear canal as the likely primary reservoir. The significance of A. otitidis at low relative abundance is unclear; however, at higher relative abundance it may be contributing to the associated inflammation. Further studies to better understand A. otitidis as a secondary otopathogen are warranted, particularly in populations at high-risk of progression to chronic suppurative otitis media and where macrolide therapies are being used.</description><subject>Abundance</subject><subject>Alloiococcus otitidis</subject><subject>Analysis</subject><subject>Antibiotics</subject><subject>Australian aborigines</subject><subject>Children</subject><subject>Children & youth</subject><subject>Commensals</subject><subject>Drug resistance in microorganisms</subject><subject>Ear</subject><subject>Ear canal</subject><subject>Eardrum</subject><subject>Ears & hearing</subject><subject>Haemophilus influenzae</subject><subject>Inflammation</subject><subject>Medical research</subject><subject>Middle ear</subject><subject>Minimum inhibitory concentration</subject><subject>Nose</subject><subject>Otitis media</subject><subject>Pathogens</subject><subject>Pharynx</subject><subject>Polymerase chain reaction</subject><subject>Risk groups</subject><subject>Studies</subject><subject>Territory</subject><issn>1472-6815</issn><issn>1472-6815</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNkk1v1DAQhiMEoqVw5oYsceGS1mPn84K0rChUqsSHerccZ7LrKvEEOyniX_ET67Bl6aIiIR9sjZ95Zzyvk-Ql8FOAqjiDrBRpUUGegkgBHiXH-8jje-ej5FkI15xDWUH5NDkSkktZgzxOfn6ZtZvspCd7g-zz-iujjqH2rLXBbLXfIOs8DezCtXaDjubAVnOYvO6tdsxsbd96dOy7nbZMm3lCRlHNBjZga_UuPqLvyMcK5FiYx5H8FJhmnvooTp6t-p4sGTImqv9Kj8WZXpiAhlyr_Q826mlLsYPnyZNO9wFf3O0nydX5-6v1x_Ty04eL9eoybQpeT2lhoC15pnPRZE1WF2hKXmMlqjqTvBE1Qpl3HKWEvAXQKI2AvC6xE6UQ2MqT5O1Odpyb-BSDbnmzGr0dYjeKtFWHN85u1YZulMyzIhNZFHi3E2gs_UPg8MbQoBbD1GKYAqEAosibuy48fZsxTGqItmDfa4fRikhVOa-qihf_gcqa5xXPeURf_4Ve0-xdnOZClQBxEvCH2ugelXUdxTbNIqpWucygyDgsZU8foOJqcbDRO-xsjB8knO0SjKcQPHb7kQBXy59-YAiv7lux539_YnkLlgXz3g</recordid><startdate>20121003</startdate><enddate>20121003</enddate><creator>Marsh, Robyn L</creator><creator>Binks, Michael J</creator><creator>Beissbarth, Jemima</creator><creator>Christensen, Peter</creator><creator>Morris, Peter S</creator><creator>Leach, Amanda J</creator><creator>Smith-Vaughan, Heidi C</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20121003</creationdate><title>Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen</title><author>Marsh, Robyn L ; Binks, Michael J ; Beissbarth, Jemima ; Christensen, Peter ; Morris, Peter S ; Leach, Amanda J ; Smith-Vaughan, Heidi C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b609t-6c1d704a52b4b496ec709e8289430b29e175f0e3315d11ae3c21597ef2722ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abundance</topic><topic>Alloiococcus otitidis</topic><topic>Analysis</topic><topic>Antibiotics</topic><topic>Australian aborigines</topic><topic>Children</topic><topic>Children & youth</topic><topic>Commensals</topic><topic>Drug resistance in microorganisms</topic><topic>Ear</topic><topic>Ear canal</topic><topic>Eardrum</topic><topic>Ears & hearing</topic><topic>Haemophilus influenzae</topic><topic>Inflammation</topic><topic>Medical research</topic><topic>Middle ear</topic><topic>Minimum inhibitory concentration</topic><topic>Nose</topic><topic>Otitis media</topic><topic>Pathogens</topic><topic>Pharynx</topic><topic>Polymerase chain reaction</topic><topic>Risk groups</topic><topic>Studies</topic><topic>Territory</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marsh, Robyn L</creatorcontrib><creatorcontrib>Binks, Michael J</creatorcontrib><creatorcontrib>Beissbarth, Jemima</creatorcontrib><creatorcontrib>Christensen, Peter</creatorcontrib><creatorcontrib>Morris, Peter S</creatorcontrib><creatorcontrib>Leach, Amanda J</creatorcontrib><creatorcontrib>Smith-Vaughan, Heidi C</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC ear, nose and throat disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marsh, Robyn L</au><au>Binks, Michael J</au><au>Beissbarth, Jemima</au><au>Christensen, Peter</au><au>Morris, Peter S</au><au>Leach, Amanda J</au><au>Smith-Vaughan, Heidi C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen</atitle><jtitle>BMC ear, nose and throat disorders</jtitle><addtitle>BMC Ear Nose Throat Disord</addtitle><date>2012-10-03</date><risdate>2012</risdate><volume>12</volume><issue>1</issue><spage>11</spage><epage>11</epage><pages>11-11</pages><artnum>11</artnum><issn>1472-6815</issn><eissn>1472-6815</eissn><abstract>Otitis media is endemic in remote Indigenous communities of Australia's Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM) in this population. The aims of this study were to determine the presence, antibiotic susceptibility and bacterial load of A. otitidis in nasopharyngeal and ear discharge swabs collected from Indigenous Australian children with AOM with perforation.
Paired nasopharyngeal and ear discharge swabs from 27 children with AOM with perforation were tested by A. otitidis quantitative PCR (qPCR). Positive swabs were cultured for 21 days. Total and respiratory pathogen bacterial loads in A. otitidis-positive swabs were determined by qPCR.
A. otitidis was detected by qPCR in 11 ear discharge swabs from 10 of 27 (37%) children, but was not detected in paired nasopharyngeal swabs. A. otitidis was cultured from 5 of 11 qPCR-positive swabs from four children. All A. otitidis isolates had minimum inhibitory concentrations consistent with macrolide resistance. All A. otitidis qPCR-positive swabs were culture-positive for other bacteria. A. otitidis bacterial load ranged from 2.2 × 104-1.1 × 108 cells/swab (median 1.8 × 105 cells/swab). The relative abundance of A. otitidis ranged from 0.01% to 34% of the total bacterial load (median 0.7%). In 6 of 11 qPCR-positive swabs the A. otitidis relative abundance was <1% and in 5 of 11 it was between 2% and 34%. The A. otitidis bacterial load and relative abundance measures were comparable to that of Haemophilus influenzae.
A. otitidis can be a dominant species in the bacterial communities present in the ear discharge of Indigenous children with AOM with perforation. The absence of A. otitidis in nasopharyngeal swabs suggests the ear canal as the likely primary reservoir. The significance of A. otitidis at low relative abundance is unclear; however, at higher relative abundance it may be contributing to the associated inflammation. Further studies to better understand A. otitidis as a secondary otopathogen are warranted, particularly in populations at high-risk of progression to chronic suppurative otitis media and where macrolide therapies are being used.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>23033913</pmid><doi>10.1186/1472-6815-12-11</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abundance Alloiococcus otitidis Analysis Antibiotics Australian aborigines Children Children & youth Commensals Drug resistance in microorganisms Ear Ear canal Eardrum Ears & hearing Haemophilus influenzae Inflammation Medical research Middle ear Minimum inhibitory concentration Nose Otitis media Pathogens Pharynx Polymerase chain reaction Risk groups Studies Territory |
| title | Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen |
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