Which bacteria are associated with acute otitis media (AOM) in neonates?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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In the perinatal period, the Escherichia coli, Enterococcus species, and group B streptococci are the etiologic agents most commonly responsible for sepsis and meningitis. These agents are often recovered from the middle ear, though the total percentage is probably less than 10% of neonates with AOM.

S pneumoniae remains the most common pathogen responsible for AOM in all age groups, including neonates. The nonencapsulated H influenzae and nontypeable varieties may be invasive in these infants and constitute the second most common pathogens recovered from the ear.

Because bacteremia is common in all neonates with AOM, tympanocentesis should be performed for both diagnosis and therapy in any infant with signs of AOM or generalized sepsis and any middle ear effusion. This should be part of any septic workup in neonates.

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