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Journal of Clinical Microbiology, May 1998, p. 1185-1188, Vol. 36, No. 5
Department of Microbiology and
Immunology,1
Department of
Pediatrics,2 and
Department of
Otorhinolaryngology/ Head & Neck Surgery,3
Faculty of Medicine, American University of Beirut, New York, New York
10022
Received 26 August 1997/Returned for modification 22 December
1997/Accepted 30 January 1998
We developed and evaluated a two-step PCR-based assay with
universal primers and genus- or species-specific primers for the detection of the most prevalent bacterial etiologies of otitis media
with effusion (OME) in children from Lebanese hospitals. These
etiologies included Haemophilus, Streptococcus,
and Moraxella (Branhamella)
catarrhalis, which were detected in middle-ear effusion (MEE) samples taken from children with OME. A total of 47 MEE samples
were aspirated from 36 patients during insertion of a tympanostomy tube
performed particularly for OME. The duration of effusion in all
patients was
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Two-Step PCR-Based Assay for Identification of Bacterial Etiology
of Otitis Media with Effusion in Infected Lebanese Children
2 months. DNA was extracted from MEE samples, and PCR
was initially done with DNA extracts by using the universal primers
RW01 and DG74, which flank an ~370-bp fragment found in the 16S rRNA
gene of all bacterial species. For the identification of specific
bacteria, we used in three separate reaction mixtures the following
genus- or species-specific primers: (i) a
Haemophilus-specific probe (probe RDR125) as a primer along
with DG74, (ii) a Streptococcus-specific primer (primer
STR1; designed by us) along with DG74, and (iii) an M. catarrhalis-specific primer pair (primer pair MCA1-MCA2). Thirty-five MEE samples (74.5%) gave the expected 370-bp band, indicating the presence of bacterial DNA in the tested samples. Of the
35 PCR-positive samples tested, 33 (94.3%) were positive for
Haemophilus, 3 (8.6%) were positive for
Streptococcus, and 10 (28.6%) were positive for M. catarrhalis. Ten samples (28.6%) exhibited a mixed infection and
were positive for both Haemophilus and M. catarrhalis. Culture was simultaneously performed for all 47 MEE
samples. Ten of the 47 MEE samples (21.3%) exhibited bacterial growth.
These 10 were PCR positive for bacterial DNA. The remaining 25 PCR-positive samples were negative by culture, thus showing about 53%
discordance between PCR results and those of culture. The PCR assay
proved to be more sensitive than culture, more rapid, less cumbersome,
and more cost-effective than the available PCR-Southern hybridization-based assays.
*
Corresponding author. Mailing address: Department of
Microbiology and Immunology, American University of Beirut, 850, 3rd Ave., New York, NY 10022. Phone: (212) 583-7600. Fax: (212) 583-7650. E-mail: gmatar{at}aub.edu.lb.
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