Characterizing the Middle and External Ear Microbiome in Pediatric Patients with and Without OME

Saturday, October 11, 2025

9:36 AM - 9:42 AM EDT

Location: 233-234

Disclosure(s):

Alfonso Caetta, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amy L. Hughes, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: As the pediatric middle ear microbiome remains uncharacterized, this is the first study to use 16srRNA gene sequence analysis to compare samples obtained from both children with chronic effusions requiring ventilation tubes and those without infectious ear pathologies.

Methods: This is a cross-sectional study including 20 pediatric patients receiving ventilation tubes for chronic otitis media and 6 patients with otherwise normal middle ears undergoing cochlear implantation from June 2023 to June 2024 by multiple pediatric otolaryngologists at a stand alone children’s hospital. Middle ear fluid aspirates or antral swabs, as well as external ear canal swabs, were obtained intraoperatively. All samples were analyzed using 16srRNA gene sequence analysis to characterize the microbiome. Outcome measures include number of gene sequencing reads, microbial genera, relative abundance of microbes, and richness and diversity of microbes. Independent variables include age, sex, race, duration of symptoms, antibiotics in the last year, past medical history, tobacco exposure, and daycare.

Results: 25% (5/20) of chronic effusion aspirates resulted with pathogens, while 75% (15/20) had sterile fluid based on highly sensitive RNA analysis. The control cochlear implant middle ear antral swabs were 100% (6/6) sterile. There were significantly more sequencing reads in chronic effusion aspirates as compared to control antral swabs (p < 0.01). Of the 5 chronic effusion aspirates positive for pathogens, Staphylococcus (5/5), Streptococcus (2/5), Alloiococcus (2/5), and Turicella (2/5) were present. 80% (4/5) of patients with positive middle ear fluid aspirates were treated with antibiotics for ear infections in the prior year, as compared to 40% (6/15) with sterile fluid aspirates.

Conclusions: Pediatric middle ear aspirates for chronic effusions requiring ventilation tube placement were not sterile in 5/20 cases, as compared to 0/6 control swabs which were widely sterile using a highly sensitive 16srRNA analysis. There is a positive correlation between antibiotic use and nonsterile middle ear effusions.

Presenting Author(s)

Alfonso Caetta, MD

Resident, PGY4
University of Connecticut
West Hartford, CT, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

DA

Davis Aasen, MD

University of Connecticut, United States

Disclosure information not submitted.
Patrick Adamczyk, BS

Medical Student
University of Connecticut
Farmington, CT, United States

Disclosure information not submitted.
HY

Hanshu Yuan, MS

University of Connecticut, United States

Disclosure information not submitted.
Christopher R. Grindle, MD

Associate Professor of Clinical Otolaryngology
Connecticut Childrens
Hartford, CT, United States

Disclosure information not submitted.
Scott R. Schoem, MD

Director of Otolaryngology
Connecticut Childrens Medical Center

Disclosure information not submitted.
YZ

Yanjiao Zhou, MD PHD

University of Connecticut, United States

Disclosure information not submitted.
DR

Daniel Roberts, MD PHD

Connecticut ENT Associates\r, United States

Disclosure information not submitted.

Senior Author(s)

Amy L. Hughes, MD

Assistant Professor in Otolaryngology
Connecticut Children's
West Hartford, CT, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.