The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media

Andrea Coleman; Amanda Wood; Seweryn Bialasiewicz; Robert S Ware; Robyn L Marsh; Anders Cervin

doi:10.1186/s40168-018-0577-2

The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media

Microbiome. 2018 Nov 5;6(1):199. doi: 10.1186/s40168-018-0577-2.

Authors

Andrea Coleman^{1

2}, Amanda Wood³, Seweryn Bialasiewicz⁴, Robert S Ware⁵, Robyn L Marsh⁶, Anders Cervin^{7

8}

Affiliations

¹ Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia. a.coleman2@uq.edu.au.
² Queensland Pediatric Infectious Disease Laboratory, Centre for Children's Health Research, Children's Health Queensland Hospital, Queensland University of Technology, Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, Queensland, 4101, Australia. a.coleman2@uq.edu.au.
³ The Deadly Ears Program, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.
⁴ Queensland Pediatric Infectious Disease Laboratory, Centre for Children's Health Research, Children's Health Queensland Hospital, Queensland University of Technology, Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, Queensland, 4101, Australia.
⁵ Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
⁶ Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
⁷ Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁸ Head & Neck Surgery, Department of Otolaryngology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

Abstract

Background: Otitis media (OM) imposes a great burden of disease in indigenous populations around the world, despite a variety of treatment and prevention programs. Improved understanding of the pathogenesis of OM in indigenous populations is required to advance treatment and reduce prevalence. We conducted a systematic review of the literature exploring the upper airway and middle ear microbiota in relation to OM in indigenous children.

Methods: Papers targeting microbiota in relation to OM in children < 18 years indigenous to Australia, New Zealand, North America, and Greenland were sought. MEDLINE, CINAHL, EMBASE, Cochrane Library, and Informit databases were searched using key words. Two independent reviewers screened titles, abstracts, and then full-text papers against inclusion criteria according to PRISMA guidelines.

Results: Twenty-five papers considering indigenous Australian, Alaskan, and Greenlandic children were included. There were high rates of nasopharyngeal colonization with the three main otopathogens (Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis) in indigenous children with OM. Middle ear samples had lower rates of otopathogen detection, although detection rates increased when molecular methods were used. Pseudomonas aeruginosa and Staphylococcus aureus were commonly detected in middle ear discharge of children with chronic suppurative OM. There was a significant heterogeneity between studies, particularly in microbiological methods, which were largely limited to culture-based detection of the main otopathogens.

Conclusions: There are high rates of otopathogen colonization in indigenous children with OM. Chronic suppurative OM appears to be associated with a different microbial profile. Beyond the main otopathogens, the data are limited. Further research is required to explore the entire upper respiratory tract/middle ear microbiota in relation to OM, with the inclusion of healthy indigenous peers as controls.

Keywords: Indigenous; Microbiota; Otitis media; Pediatrics; Systematic review.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Adolescent
Australia
Child
Child, Preschool
Ear, Middle / microbiology*
Greenland
Haemophilus influenzae / isolation & purification*
Humans
Infant
Infant, Newborn
Microbiota
Moraxella catarrhalis / isolation & purification*
Nasopharynx / microbiology*
New Zealand
North America
Otitis Media / microbiology*
Population Groups
Streptococcus pneumoniae / isolation & purification*