Faculty Collaboration Database

Direct Analysis of Pathogenic Structures Affixed to the Tympanic Membrane during Chronic Otitis Media. Otolaryngol Head Neck Surg 2018 Jul;159(1):117-126

Date

03/28/2018

Pubmed ID

29587128

Pubmed Central ID

PMC6030439

DOI

10.1177/0194599818766320

Scopus ID

2-s2.0-85045295547 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

Objective To characterize otitis media-associated structures affixed to the mucosal surface of the tympanic membrane (TM) in vivo and in surgically recovered in vitro samples. Study Design Prospective case series without comparison. Setting Outpatient surgical care center. Subjects and Methods Forty pediatric subjects scheduled for tympanostomy tube placement surgery were imaged intraoperatively under general anesthesia. Postmyringotomy, a portable optical coherence tomography (OCT) imaging system assessed for the presence of any biofilm affixed to the mucosal surface of the TM. Samples of suspected microbial infection-related structures were collected through the myringotomy incision. The sampled site was subsequently reimaged with OCT to confirm collection from the original image site on the TM. In vitro analysis based on confocal laser scanning microscope (CLSM) images of fluorescence in situ hybridization-tagged samples and polymerase chain reaction (PCR) provided microbiological characterization and verification of biofilm activity. Results OCT imaging was achieved for 38 of 40 subjects (95%). Images from 38 of 38 (100%) of subjects observed with OCT showed the presence of additional microbial infection-related structures. Thirty-four samples were collected from these 38 subjects. CLSM images provided evidence of clustered bacteria in 32 of 33 (97%) of samples. PCR detected the presence of active bacterial DNA signatures in 20 of 31 (65%) of samples. Conclusion PCR and CLSM analysis of fluorescence in situ hybridization-stained samples validates the presence of active bacteria that have formed into a middle ear biofilm that extends across the mucosal layer of the TM. OCT can rapidly and noninvasively identify middle ear biofilms in subjects with severe and persistent cases of otitis media.

Author List

Monroy GL, Hong W, Khampang P, Porter RG, Novak MA, Spillman DR, Barkalifa R, Chaney EJ, Kerschner JE, Boppart SA

Author

Wenzhou Hong DVM, PhD Assistant Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Biofilms
Child
Humans
Otitis Media
Prospective Studies
Tomography, Optical Coherence
Tympanic Membrane