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Background  Acute Otitis Media (AOM) is an important and common disease of childhood. Bacteria isolated from cases of clinically problematic AOM in German children were identified and characterized.    Methods  In a prospective non-interventional study in German children between 3 months and less than 60 months of age with Ear, Nose and Throat Specialist –confirmed AOM, middle ear fluid was obtained by tympanocentesis (when clinically indicated) or by careful sampling of otorrhea through/at an existing perforation.    Results  In 100 children with severe AOM,  Haemophilus influenzae  was identified in 21% (18/21, 85.7% were non-typeable [NTHi]),  Streptococcus pneumoniae  in 10%,  S. pyogenes  in 13% and  Moraxella catarrhalis  in 1%.  H. influenzae  was the most frequently identified pathogen in children from 12 months of age.  H. influenzae  and  S. pneumoniae  were equally prevalent in children aged 3–11 months, but  S. pyogenes  was most frequently isolated in this age group. NTHi AOM disease appeared prevalent in all ages.    Conclusions  NTHi,  S. pneumoniae  and  S. pyogenes  are implicated as important causes of complicated AOM in children in Germany. NTHi disease appears prevalent in all ages. The impact of vaccination to prevent NTHi and  S. pneumoniae  AOM may be substantial in this population and is worth investigating.

bmc infectious diseases

Identification and characterization of the bacterial etiology of clinically problematic acute otitis media after tympanocentesis or spontaneous otorrhea in German children