Are there microbiological markers to predict recurrent acute otitis media?

The nasopharynx is a natural reservoir for several bacterial species, including Streptococcus pneumoniae and Haemophilus influenzae. Carriership is a potential mechanism for pathogenicity, since bacteria might invade the Eustachian tube and cause middle ear disease. Whether the pattern of nasopharyngeal colonization is different in infection prone vs healthy children is still a matter of controversy. In several studies it has been shown that H. influenzae is carried significantly more often in otitis-prone children compared with healthy control children. Colonization with H. influenzae in young children may be regarded as a candidate for a microbiological marker for recurrent episodes of acute otitis media.