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Background  Otitis media (OM) affects ≥80% of children before the age of three. OM can arise following co-infection with influenza A virus (IAV) and the bacterium  Streptococcus pneumoniae . We have previously shown that H3 IAV strains (such as Udorn/72) induced a higher rate of bacterial OM than H1 strains (such as PR8/34). This was associated with more efficient replication of H3 strains in the middle ear.    Findings  Here, we assess if the increased replication of IAV strains such as Udorn/72 in the middle ear is dependent upon the binding of the viral HA to α2,6-linked sialic acid. Using murine and  in vitro  models, the present study shows that recognition of α2,6-linked sialic acid was not required to facilitate bacterial OM.    Conclusions  Taken together, these data suggest that other features of the HA mediate bacterial OM.

Influenza A virus induced bacterial otitis media is independent of virus tropism for α2,6-linked sialic acid