Widening Differences in Acute Otitis Media Study Populations

The article “Acute Otitis Media Caused by Moraxella catarrhalis: Epidemiologic and Clinical Characteristics” in this issue of Clinical Infectious Diseases is one of many interesting papers by the Beer-Sheva, Israel, Pediatric Infectious Disease Group led by Ron Dagan and Eugene Leibovitz. These investigators are prominent authorities in acute otitis media (AOM) and nasopharynx colonization in children and continue to evaluate their extensive data. In the current article they describe results relating to the role of Moraxella catarrhalis in AOM [1], a topic recently reviewed in this journal [2]. The main findings are as follows. First, M. catarrhalis is more often observed in mixed AOM infections than as a solo pathogen, compared with Streptococcus pneumoniae and nontypable Haemophilus influenzae . Second, as a solo pathogen M. catarrhalis is isolated more often in children aged <12 months and in first episodes. Third, M. catarrhalis causes less spontaneous perforation of the tympanic membrane (suggestive of somewhat less virulence) than S. pneumoniae or nontypable H. influenzae .