Pediatrics

Identification of biofilms in post-tympanostomy tube otorrhea

  1. Winslo K. Idicula MD1,2,*,
  2. Joseph A. Jurcisek BS3,
  3. Nathan D. Cass MS4,
  4. Syed Ali MS4,
  5. Steven D. Goodman PhD3,
  6. Charles A. Elmaraghy MD1,2,
  7. Kris R. Jatana MD1,2 and
  8. Lauren O. Bakaletz PhD3

Version of Record online: 4 JAN 2016

DOI: 10.1002/lary.25826

Issue

The Laryngoscope

The Laryngoscope

Volume 126, Issue 8, pages 1946–1951, August 2016


Additional Information

How to Cite

Idicula, W. K., Jurcisek, J. A., Cass, N. D., Ali, S., Goodman, S. D., Elmaraghy, C. A., Jatana, K. R. and Bakaletz, L. O. (2016), Identification of biofilms in post-tympanostomy tube otorrhea. The Laryngoscope, 126: 1946–1951. doi: 10.1002/lary.25826

Author Information

  1. 1

    Department of Otolaryngology–Head and Neck Surgery, Wexner Medical Center at The Ohio State University

  2. 2

    Department of Otolaryngology–Head and Neck Surgery, Nationwide Children's Hospital

  3. 3

    Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital

  4. 4

    The Ohio State University College of Medicine, Columbus, Ohio, U.S.A

*Send correspondence to Winslo Idicula, MD, 2201 N. Ursula St, Apt '441. Aurora, CO 80045. E-mail: winslo.idicula@gmail.com

  1. Financial Disclosure: A NIH/NIDCD grant (R01DC011818) to l.o.b. and s.d.g. was used for this research. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Publication History

  1. Issue online: 18 JUL 2016
  2. Version of Record online: 4 JAN 2016
  3. Manuscript Accepted: 16 NOV 2015
  4. Manuscript Revised: 5 NOV 2015
  5. Manuscript Received: 18 JUL 2015

Funded by

  • NIH/NIDCD. Grant Number: R01DC011818

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Enhanced Article (HTML) Get PDF (323K)Get PDF (323K)

Keywords:

  • Post-tympanostomy tube otorrhea;
  • anti-IHF;
  • biofilms;
  • tympanostomy tube;
  • acute otitis media;
  • chronic otitis media with effusion

Objectives/Hypothesis

Otitis media is a common problem in the pediatric population. Despite antibiotic therapy, post-tympanostomy otorrhea can be difficult to treat. Biofilms have been shown to play a role in chronic and recurrent otitis media and are implicated in otorrhea. This study investigated both the microbial composition and the presence of biofilm fragments rich in extracellular DNA (eDNA) and the bacterial DNA-binding protein, integration host factor (IHF), in post-tympanostomy tube otorrhea.

Study Design

Clinical samples.

Methods

Institutional review board approval was obtained, and samples were recovered from pediatric patients with tympanostomy tubes and persistent otorrhea for both microbial culture and biofilm analysis. For biofilm assessment, frozen samples were sectioned and then labeled using a rabbit anti-IHF, which was detected with goat anti-rabbit IgG conjugated to AlexaFluor 594. Samples were then counterstained with 4',6-diamidino-2-phenylindole (DAPI) to detect DNA, and images were captured by inverted light microscopy.

Results

Of 15 pediatric otorrhea samples analyzed, nine (60%) contained solids that were positive for labeling of IHF in association with a lattice of eDNA, and 75% yielded positive bacterial cultures. Bacterial culture results included H. influenzae, Methicillin-resistant Staphylococcus aureus, S. pneumoniae, M. catarrhalis, and P. aeruginosa.

Conclusion

Positive labeling of otorrhea solids for eDNA and IHF, in combination with microbiological culture results, indicated that biofilms likely played a key role in chronic otorrhea. Moreover, as a known critical structural component of biofilms, these findings suggest that DNABII proteins in association with eDNA may serve as an important therapeutic target in post-tympanostomy tube otorrhea.

Level of Evidence

NA. Laryngoscope, 126:1946–1951, 2016

View Full Article (HTML) Enhanced Article (HTML) Get PDF (323K)Get PDF (323K)