Detection of Haemophilus influenzae in adenoids and nasopharyngeal secretions by polymerase chain reaction.

Haemophilus influenzae in the nasopharynx is thought to be related to the pathogenesis of otitis media with effusion (OME). However, the positive rate measured by the conventional culture method is not high enough for bacterial infection to be considered the chief pathogenic factor. Polymerase chain reaction (PRC) and the conventional culture method were applied to detect H. influenzae in the adenoids and nasopharyngeal secretions of 17 children with OME (2 to 7 years of age). The percentage of P6-positive adenoid samples was 82.4% while 70.6% were culture positive. In nasopharyngeal secretions, 88.2% were P6-positive and 64.7% were culture positive. All samples in which H. influenzae was cultured were positive with PCR. The positive rate was significantly greater with PCR than with the culture method, and it showed a significant concordance between adenoids and nasopharyngeal secretions (p = 0.0027). These findings suggest that the presence of H. influenzae in the nasopharynx is more common in children with OME than previously reported, and that H. influenzae in adenoids might play an important role in OME.