Otitis Media in Children: Risk Factors & Causative Organisms

Background: Otitis media (OM) is an important health problem among children. It is the one of the leading causes of bacterial infections and antibiotic prescriptions.  Patients and Methods: Three hundred patients with OM [147 with acute suppurative otitis media (ASOM), 80 with secretory otitis media (SOM) and 73 with chronic suppurative otitis media (CSOM)] ranging in age from 3 months -12 years were investigated for possible risk factors of OM. Age- and sex- matched healthy children served as controls (n=300).  Bacteriological examinations were completed for 178 patients (110 with ASOM and 68 with CSOM) with discharge from their ears.  Results: Residence in rural areas, artificial feeding, low socioeconomic standard (SES), parental smoking, allergic rhinitis, adenoid hypertrophy, chronic tonsillitis, URTI, LRTI and introduction of foreign body (FB) into ears were major risk factors for the occurrence of OM (P<0.01). Unilateral affection was more significantly (P<0.001) found in ASOM and CSOM, while bilateral affection was more significantly found in SOM (P<0.01). Bacteriological examination showed that the prevailing bacteria in cases of ASOM were S. pneumoniae (24.8%), Staph. aureus (24.8%), P. aeruginosa (15.2%), H. influenzae (9.5%) and S. pyogenes (7.6%). On the other hand, the prevailing bacteria in CSOM were Proteus mirabilis (31%), P. aeruginosa (26.8%), Klebsiella species (14.1%), Staph. aureus (8.5%) and E. coli (5.6%). Conclusion:  many risk factors have a role in the occurrence of OM in children and control of these factors may decrease the incidence of this disease. Many bacterial species (S. pneumoniae and Staph. aureus in ASOM and Proteus mirabilis, P. aeruginosa and Klebsiella in CSOM) are the causative organisms of this disease in our locality. Key words: Risk factor – acute suppurative otitis media – chronic suppurative otitis media – secretory otitis media – causative bacteria of OM.