Comparison of Culture and PCR Methods in Detection of Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis in Children with Otitis Media with Effusion

Objective: The etiology and pathogenesis of otitis media with effusion (OME) is still unclear despite many studies within the last four decades. Polymerase chain reaction (PCR) based procedures are suggested for detection of the causative bacteria supposed to inflict multiple infections. In the current study, culture and PCR based approaches were used to detect the frequency of Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis, which have been known as common pathogens in middle ear effusions (MEE) of patients with otitis media. Material and Methods: The DNAs of these three bacteria were detected by standard and multiplex PCR techniques in MEE specimens and their diagnostic values were evaluated in comparison to the conventional culture method. Results: Samples from 67 OME suspected children were analysed retrospectively. Two H. influenzae and two M. catarrhalis isolates were recovered by conventional culture method (6.0%; 4/67). Out of the 67 samples, seven S. pneumoniae, nine H. influenzae, and eleven M. catarrhalis isolates were detected vith PCR. In five samples, two concurrent bacteria were detected in following combinations: two S. pneumoniae and H. influenzae, two S. pneumoniae and M. catarrhalis, and one H. influenzae and M. catarrhalis. Sensitivity, specificity, positive predictive value and negative predictive value rates of the PCR technique were 100.0%, 71.4%, 18.2% and 100.0%, respectively. The difference between culture and PCR was statistically significant (p<0.001). Conclusion: Although the specificity and positive predictive values are low, PCR, which allows rapid screening is feasible for detecting the most common fastidious bacteria that lead to OME.