Mucosal Biofilm Formation on Middle-Ear Mucosa in the Chinchilla Model of Otitis Media

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Abstract
Otitis media (OM) is the most common reason for an ill child to visit a physician or other health care professional and is the most common reason for a child in the United States to receive antibiotics or undergo a general anesthetic.1 The underlying pathophysiology of OM is poorly understood although it is clear that OM results from an interplay of infectious, environmental, and host genetics factors.2,3 Although most effusions from acute OM are culture-positive for bacteria (predominantly Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis), the majority of chronic effusions are cultural-negative, refractory to antibiotic treatment, and positive for a variety of inflammatory mediators.4-6 These observations led to the concept that chronic OM effusion (OME) is not a bacterial process but rather represents a sterile, inflammatory process directed against residual bacterial metabolites.7