Skip to main content

Advertisement

SpringerLink
Log in

Mucosal biofilm detection in chronic otitis media: a study of middle ear biopsies from Greenlandic patients

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The objectives of this study were to examine middle ear biopsies from Greenlandic patients with chronic otitis media (COM) for the presence of mucosal biofilms and the bacteria within the biofilms. Thirty-five middle ear biopsies were obtained from 32 Greenlandic COM patients admitted to ear surgery. All biopsies were examined by means of peptide nucleic acid-fluorescent in situ hybridization (PNA-FISH), and if possible culture and polymerase chain reaction (PCR) of the 16s rDNA and sequencing. Light microscopy and confocal laser scanning microscopy were used. Skin biopsies from 23 of the patients served as controls. PNA-FISH showed morphological signs of biofilms in 15 out of 35 (43 %) middle ear biopsies. In the control skin biopsies, there were signs of biofilms in eight out of 23 biopsies (30 %), probably representing skin flora. PCR and 16s sequencing detected bacteria in seven out of 20 (35 %) usable middle ear biopsies, and in two out of ten (20 %) usable control samples. There was no association between biofilm findings and PCR and 16s sequencing. Staphylococci were the most common bacteria in bacterial culture. We found evidence of bacterial biofilms in 43 % of middle ear biopsies from patients COM. The findings may indicate that biofilms are a part of the pathogenesis in recurrent episodes of ear discharge in COM, but further investigations are necessary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Burmølle M, Thomsen TR, Fazli M, Dige I, Christensen L, Homøe P, Tvede M, Nyvad B, Tolker-Nielsen T, Givskov M, Moser C, Kirketerp-Møller K, Johansen HK, Høiby N, Jensen PØ, Sørensen SJ, Bjarnsholt T (2010) Biofilms in chronic infections—a matter of opportunity—monospecies biofilms in multispecies infections. FEMS Immunol Med Microbiol 59:324–336

    PubMed  Google Scholar 

  2. Macassey E, Dawes P (2008) Biofilms and their role in otorhinolaryngological disease. J Laryngol Otol 122:1273–1278

    Article  CAS  PubMed  Google Scholar 

  3. Rayner MG, Zhang Y, Gorry MC, Chen Y, Post JC, Ehrlich GD (1998) Evidence of bacterial metabolic activity in culture—negative otitis media with effusion. JAMA 279:296–299

    Article  CAS  PubMed  Google Scholar 

  4. Coates H (2004) Chronic suppurative otitis media without cholesteatoma. In: Bluestone CD, Alper CM, Mandel EM, Dohar JE, Casselbrant ML (eds) Advanced therapy of otitis media. B.C. Decker Inc, Ontario, pp 299–305

    Google Scholar 

  5. Hall-Stoodley L, Hu FZ, Gieseke A, Nistico L, Nguyen D, Hayes J, Forbes M, Greenberg DP, Dice B, Burrows A, Wackym PA, Stoodley P, Post JC, Ehrlich GD, Kerschner JE (2006) Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media. JAMA 296:202–211

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Homøe P, Bjarnsholt T, Wessman M, Sørensen HC, Johansen HK (2009) Morphological evidence of biofilm formation in Greenlanders with chronic suppurative otitis media. Eur Arch Otorhinolaryngol 266:1533–1538

    Article  PubMed  Google Scholar 

  7. Lee MR, Pawlowski KS, Luong A, Furze AD, Roland PS (2009) Biofilm presence in humans with chronic suppurative otitis media. Otolaryngol Head Neck Surg 141:567–571

    Article  PubMed  Google Scholar 

  8. Saunders J, Murray M, Alleman A (2011) Biofilms in chronic suppurative otitis media and cholesteatoma: scanning electron microscopy findings. Am J Otolaryngol 32:32–37

    Article  PubMed  Google Scholar 

  9. Homøe P, Christensen RB, Bretlau P (1996) Prevalence of otitis media in a survey of 591 unselected Greenlandic children. Int J Pediatr Otorhinolaryngol 36:215–230

    Article  PubMed  Google Scholar 

  10. Jensen RG, Koch A, Homøe P (2012) Long-term tympanic membrane pathology dynamics and spontaneous healing in chronic suppurative otitis media. Pediatr Infect Dis J 31:139–144

    Article  PubMed  Google Scholar 

  11. Perry-O’Keefe H, Rigby S, Oliveira K, Sorensen D, Stender H, Coull J, Hyldig-Nielsen JJ (2001) Identification of indicator microorganisms using a standardized PNA FISH method. J Microbiol Methods 47:281–292

    Article  PubMed  Google Scholar 

  12. Oliveira K, Procop GW, Wilson D, Coull J, Stender H (2002) Rapid identification of Staphylococcus aureus directly from blood cultures by fluorescence in situ hybridization with peptide nucleic acid probes. J Clin Microbiol 40:247–251

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Bjarnsholt T, Alhede M, Alhede M, Eickhardt-Sorensen SR, Moser C, Kuhl M, Jensen PO, Hoiby N (2013) The in vivo biofilm. Trends Microbiol 21:466–474

    Article  CAS  PubMed  Google Scholar 

  14. Høiby N, Frederiksen B (2000) Microbiology of Cystic fibrosis. In: Hodson Margaret E, Geddes Duncan M (eds) Cystic fibrosis. Hodder Arnold, London, pp 83–107

    Google Scholar 

  15. Römling U, Balsalobre C (2012) Biofilm infections, their resilience to therapy and innovative treatment strategies. J Intern Med 272:541–561

    Article  PubMed  Google Scholar 

  16. Vlassova N, Han A, Zenilman JM, James G, Lazarus GS (2011) New horizons for cutaneous microbiology: the role of biofilms in dermatological disease. Br J Dermatol 165:751–759

    Article  CAS  PubMed  Google Scholar 

  17. Verhoeff M, van DV, Rovers MM, Sanders EA, Schilder AG (2006) Chronic suppurative otitis media: a review. Int J Pediatr Otorhinolaryngol 70:1–12

    Article  PubMed  Google Scholar 

  18. Bonez PC, Dos Santos Alves CF, Dalmolin TV, Agertt VA, Mizdal CR, Flores VD, Marques JB, Santos RC, nraku de Campos MM (2013) Chlorhexidine activity against bacterial biofilms. Am J Infect Control

  19. Guzel A, Ozekinci T, Ozkan U, Celik Y, Ceviz A, Belen D (2009) Evaluation of the skin flora after chlorhexidine and povidone—iodine preparation in neurosurgical practice. Surg Neurol 71:207–210

    Article  PubMed  Google Scholar 

  20. Cabenda SI, Peerbooms PG, van Asselt GJ, Feenstra L, van der BS (1988) Serous otitis media (SOM). A bacteriological study of the ear canal and the middle ear. Int J Pediatr Otorhinolaryngol 16:119–124

    Article  CAS  PubMed  Google Scholar 

  21. Nistico L, Kreft R, Gieseke A, Coticchia JM, Burrows A, Khampang P, Liu Y, Kerschner JE, Post JC, Lonergan S, Sampath R, Hu FZ, Ehrlich GD, Stoodley P, Hall-Stoodley L (2011) Adenoid reservoir for pathogenic biofilm bacteria. J Clin Microbiol 49:1411–1420

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Ehrlich GD, Veeh R, Wang X, Costerton JW, Hayes JD, Hu FZ, Daigle BJ, Ehrlich MD, Post JC (2002) Mucosal biofilm formation on middle-ear mucosa in the chinchilla model of otitis media. JAMA 287:1710–1715

    Article  PubMed  Google Scholar 

  23. Kirketerp-Møller K, Jensen PO, Fazli M, Madsen KG, Pedersen J, Moser C, Tolker-Nielsen T, Hoiby N, Givskov M, Bjarnsholt T (2008) Distribution, organization, and ecology of bacteria in chronic wounds. J Clin Microbiol 46:2717–2722

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

Helle Krogh Johansen was supported by a clinical research stipend from the Novo Nordisk Foundation.

Conflict of interest

No conflict of interest to declare.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    Marcus Wessman & Preben Homøe

  2. Department of International Health, Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen N, Denmark

    Thomas Bjarnsholt & Steffen Robert Eickhardt-Sørensen

  3. Department of Clinical Microbiology, Rigshospitalet, Juliane Maries Vej 22, 2100, Copenhagen Ø, Denmark

    Thomas Bjarnsholt & Helle Krogh Johansen

Authors
  1. Marcus Wessman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Bjarnsholt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steffen Robert Eickhardt-Sørensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Helle Krogh Johansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Preben Homøe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcus Wessman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wessman, M., Bjarnsholt, T., Eickhardt-Sørensen, S.R. et al. Mucosal biofilm detection in chronic otitis media: a study of middle ear biopsies from Greenlandic patients. Eur Arch Otorhinolaryngol 272, 1079–1085 (2015). https://doi.org/10.1007/s00405-014-2886-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-2886-9

Keywords

Search

Navigation