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The unsolved problem of otitis media in indigenous populations: A systematic review of upper respiratory and middle ear microbiota in indigenous children

Andrea Coleman, Amanda Wood, View ORCID ProfileSeweryn Bialasiewicz, View ORCID ProfileRobert S Ware, Robyn L Marsh, Anders Cervin
doi: https://doi.org/10.1101/355982
Andrea Coleman
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, AustraliaQueensland Pediatric Infectious Disease Laboratory, Centre for Children’s Health Research, Children’s Health Queensland Hospital & Queensland University of Technology, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia seweryn@uq.edu.au
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  • For correspondence: a.coleman2@uq.edu.au seweryn@uq.edu.au
Amanda Wood
The Deadly Ears Program, Children’s Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia Amanda.Wood2@health.qld.gov.au
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  • For correspondence: Amanda.Wood2@health.qld.gov.au
Seweryn Bialasiewicz
Queensland Pediatric Infectious Disease Laboratory, Centre for Children’s Health Research, Children’s Health Queensland Hospital & Queensland University of Technology, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia seweryn@uq.edu.au
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  • For correspondence: seweryn@uq.edu.au
Robert S Ware
Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia r.ware@griffith.edu.au
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Robyn L Marsh
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia Robyn.Marsh@menzies.edu.au
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  • For correspondence: Robyn.Marsh@menzies.edu.au
Anders Cervin
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, AustraliaDepartment of Otolaryngology Head & Neck Surgery, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia a.cervin@uq.edu.au
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  • For correspondence: a.cervin@uq.edu.au
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Abstract

Background Otitis media (OM) imposes a great burden of disease in indigenous populations around the world, despite a variety of treatment and prevention programs. Improved understanding of the pathogenesis of OM in indigenous populations is required to advance treatment and reduce prevalence. We conducted a systematic review of the literature exploring upper airway and middle ear microbiota in relation to OM in indigenous children.

Methods Papers targeting microbiota in relation to OM in children <18 years indigenous to Australia, New Zealand, North America, and Greenland were sought. MEDLINE, CINAHL, EMBASE, Cochrane Library, and Informit databases were searched using key words. Two independent reviewers screened titles, abstracts, and then full-text papers against inclusion criteria according to PRISMA guidelines.

Results Twenty-five papers considering indigenous Australian, Alaskan and Greenlandic children were included. There were high rates of nasopharyngeal colonization with the three main otopathogens (Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis) in indigenous children with OM. Middle ear samples had lower rates of otopathogen detection, although detection rates increased when molecular methods were used. Pseudomonas aeruginosa and Staphylococcus aureus were commonly detected in middle ear discharge of children with chronic suppurative OM. There was significant heterogeneity between studies, particularly in microbiological methods, which were largely limited to culture-based detection of the main otopathogens.

Conclusions There are high rates of otopathogen colonization in indigenous children with OM. Chronic suppurative OM appears to be associated with a different microbial profile. Beyond the main otopathogens, the data are limited. Further research is required to explore the entire upper respiratory tract/ middle ear microbiota in relation to OM, with the inclusion of healthy indigenous peers as controls.

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Posted June 26, 2018.
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The unsolved problem of otitis media in indigenous populations: A systematic review of upper respiratory and middle ear microbiota in indigenous children
Andrea Coleman, Amanda Wood, Seweryn Bialasiewicz, Robert S Ware, Robyn L Marsh, Anders Cervin
bioRxiv 355982; doi: https://doi.org/10.1101/355982
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The unsolved problem of otitis media in indigenous populations: A systematic review of upper respiratory and middle ear microbiota in indigenous children
Andrea Coleman, Amanda Wood, Seweryn Bialasiewicz, Robert S Ware, Robyn L Marsh, Anders Cervin
bioRxiv 355982; doi: https://doi.org/10.1101/355982

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