Molecular Microbiological Profile of Chronic Suppurative Otitis Media
Molecular Microbiological Profile of Chronic Suppurative Otitis Media
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DOI：
10.1128/jcm.01068-16
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发表时间：
2016-10-01
影响因子：
9.4
通讯作者：
Douglas, Richard
中科院分区：
文献类型：
--
作者：
Neeff, Michel;Biswas, Kristi;Douglas, Richard
慢性化脓性中耳炎 (CSOM) 表现为脓性耳漏（耳分泌物），其特征是中耳和乳突腔的慢性炎症，在全世界造成重大疾病负担。目前的抗生素治疗以拭子培养结果为指导。由于缺乏对 CSOM 患者进行详细的分子微生物学研究，我们目前对 CSOM（以及健康耳朵）微生物群的了解仍然不完整。在这项前瞻性研究中，招募了 24 名 CSOM 患者以及 22 名健康对照者。基于培养的技术和 16S rRNA 基因扩增子测序用于分析每位患者的细菌群落。还对中耳和乳突腔有和没有胆脂瘤的患者进行了比较。一项重大发现是，许多健康对照者的中耳并未无菌，这与之前的研究结果相矛盾。然而，测序数据显示金黄色葡萄球菌以及一系列其他革兰氏阳性和革兰氏阴性生物体存在于 CSOM 和健康对照的所有亚组中。在 CSOM 和对照组的每个亚组中观察到微生物群存在较大的患者间差异，并且不存在健康或疾病特征的细菌群落“特征”。培养结果与分子数据的比较表明，基于培养的技术低估了耳内发现的细菌的多样性。这项研究首次对健康对照者和 CSOM 患者的耳朵细菌谱进行了详细检查。
Chronic suppurative otitis media (CSOM) presents with purulent otorrhea (ear discharge), is characterized by chronic inflammation of the middle ear and mastoid cavity, and contributes to a significant disease burden worldwide. Current antibiotic therapy is guided by swab culture results. In the absence of detailed molecular microbiology studies of CSOM patients, our current understanding of the microbiota of CSOM (and indeed of the healthy ear) remains incomplete. In this prospective study, 24 patients with CSOM were recruited, along with 22 healthy controls. Culture-based techniques and 16S rRNA gene amplicon sequencing were used to profile the bacterial community for each patient. Comparisons between patients with and without cholesteatoma in the middle ear and mastoid cavity were also made. A major finding was that the middle ear of many healthy controls was not sterile, which is contradictory to the results of previous studies. However, sequencing data showed that Staphylococcus aureus, along with a range of other Gram-positive and Gram-negative organisms, were present in all subgroups of CSOM and healthy controls. Large interpatient variability in the microbiota was observed within each subgroup of CSOM and controls, and there was no bacterial community "signature" which was characteristic of either health or disease. Comparisons of the culture results with the molecular data show that culture-based techniques underestimate the diversity of bacteria found within the ear. This study reports the first detailed examination of bacterial profiles of the ear in healthy controls and patients with CSOM.